Amkg LLC
Organization Active NPI Community/Retail Pharmacy · Slaughter, LA
NPI 1740726124 · NPPES record last updated Jan 25, 2022
Key facts
- NPI
- 1740726124
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHY.007445-IR (LA)
- Legal business name
- AMKG LLC
- Practice address
- 1169 Hwy 19
Slaughter, LA 70777 - Phone
- (225) 286-7773
- Fax
- (225) 286-4833
- NPI assigned
- Jan 10, 2017
- Organization subpart
- No
Authorized official
- Name
- Wimberly Gayle
- Title
- Owner
- Phone
- (225) 683-8195
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210127000568 | LA | Part B Supplier - Mass Immunization (Roster Biller Only) | 6204240641 | Practice locations: Slaughter, LA |
National Provider Directory
Locations
1169 Highway 19
#A
Slaughter, LA 70777
Phone (225) 286-7773
1169 Highway 19
Slaughter, LA 70777
Phone (225) 286-7773
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY.007445-IR | LA | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
1169 Hwy 19
Slaughter, LA 70777
Mailing address
PO Box 966
Clinton, LA 70722-0966
Phone (225) 683-8195
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2168061 | Other | PK |
Other names
- CURRY PHARMACY SLAUGHTER
Other providers in Slaughter, LA
- Emily Nicole Aldridge
- Baton Rouge Clinic, a Medical Corporation
- Jonathan Roy Blanton
- Codie C Brian
- Latonya Claiborne
- Consuela Davis
All providers in Slaughter, LA · Community/Retail Pharmacy in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.