NPIMap

Organization Active NPI

LTC Dispensary LLC

  • Long Term Care Pharmacy
  • Denham Springs, LA
National Provider Identifier
1730190240
Registry record updated Dec 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
License
5128-IR Issued in LA
Legal business name
LTC DISPENSARY LLC
Practice address
257 Florida Ave SE
Ste B
Denham Springs, LA 70726-3728
Phone
(225) 665-8606
Fax
(225) 664-4043
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2016

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

Authorized official

Name
Herman Crotwell, RPH
Title
Chief Pharmacist Owner
Phone
(225) 665-8606

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X 5128-IR LA Primary

Addresses

Primary practice location

257 Florida Ave SE
Ste B
Denham Springs, LA 70726-3728

Mailing address

257 Florida Ave SE
Ste B
Denham Springs, LA 70726-3728
Phone (225) 665-8606

Other identifiers 2

IdentifierTypeStateIssuer
2035170OtherPK
1270920MedicaidLA

Other names 1

  • LTC DISPENSARY LLC Doing business as

National Provider Directory

National Provider Directory

Locations

257 Florida Ave SE
Ste B
Denham Springs, LA 70726
Phone (225) 665-8606

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1730190240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 FLORIDA AVE SE",
            "address_2": "STE B",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707263728",
            "telephone_number": "225-665-8606",
            "fax_number": "225-664-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 FLORIDA AVE SE",
            "address_2": "STE B",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707263728",
            "telephone_number": "225-665-8606",
            "fax_number": "225-664-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LTC DISPENSARY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "CROTWELL",
        "authorized_official_first_name": "HERMAN",
        "authorized_official_title_or_position": "CHIEF PHARMACIST OWNER",
        "authorized_official_telephone_number": "225-665-8606",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "LA",
            "license": "5128-IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035170",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1270920",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LTC DISPENSARY LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denham Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.