Gordon Smith Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

428 IR Issued in LA

Legal business name

GORDON SMITH PHARMACY

Doing business as

The Drugstore

Practice address

212 Main Street
Oak Grove, LA 71263-1515

Phone

(318) 428-3212

Fax

(318) 428-7755

NPI assigned

Jan 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Wayne Nagem, RPH CCN

Title

Pharmacist in Charge

Phone

(318) 428-3212

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• The Drugstore Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1710044508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1515",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712631515",
            "telephone_number": "318-428-3212",
            "fax_number": "318-428-7755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 MAIN STREET",
            "city": "OAK GROVE",
            "state": "LA",
            "postal_code": "712631515",
            "telephone_number": "318-428-3212",
            "fax_number": "318-428-7755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GORDON SMITH PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "NAGEM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "318-428-3212",
        "authorized_official_credential": "RPH CCN"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "428 IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NARP",
            "identifier": "1909843",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123949",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Drugstore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Domingue, M.D.
• Fakhre Fakhre, M.D.
• Loren Fisher
• Gigi Danielle Frederick, LCOTA
• Callie Dartlon Freeland, LCOTA
• Green Gables Therapy LLC
• Kristina Marie Green, APRN NP-C
• Brandi Griswould
• Noli Guinigundo, M.D.
• Sonya Hagan, COTA

• Community/Retail Pharmacy in Oak Grove, LA
• Providers in Oak Grove, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.