Jonathan William Ancar
Individual provider Active NPI Pharmacist · Port Allen, LA
NPI 1740001023 · NPPES record last updated Oct 21, 2024
Key facts
- NPI
- 1740001023
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PST.025555 (LA)
- Practice address
- 3255 Hwy 1 S
Port Allen, LA 70767-5858 - Phone
- (225) 749-7454
- NPI assigned
- Oct 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.025555 | LA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.025555 | LA | Yes |
Addresses
Primary practice location
3255 Hwy 1 S
Port Allen, LA 70767-5858
Mailing address
546 Manhattan Blvd
Harvey, LA 70058-4444
Phone (504) 858-7767
Other providers in Port Allen, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.