Lake Charles Pharmaceutical Supply Company LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

LAKE CHARLES PHARMACEUTICAL SUPPLY COMPANY LLC

Practice address

1717 Oak Park Blvd Ste 110
Lake Charles, LA 70601-8977

Phone

(337) 494-2990

Fax

(337) 494-2550

NPI assigned

Dec 26, 2006

Organization subpart

Yes

Parent organization

SOUTHWEST LOUISIANA HOSPITAL ASSOCIATIONAs reported in NPPES

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

Authorized official

Name

Amanda Joiner SaltzmanNPI 1043553522

Title

Pharmacy Manager

Phone

(337) 494-2990

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Medical Plaza Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Part of

John W Digiglia

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Swlhs LLC

  • Internal Medicine Physician
  • Lake Charles, LA
  • NPI 1669494654

  Member Of

  NPD member

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Joiner Saltzman, PHARMD

  • Pharmacist
  • Lake Charles, LA
  • NPI 1043553522
  NPD Authorized official
• Margot Alexis Allured, PHARMD

  • Pharmacist
  • Lake Charles, LA
  • NPI 1639998347
  NPD
• Juanita Joy Davidson, PHARM D

  • Pharmacist
  • Lake Charles, LA
  • NPI 1093523722
  NPD
• Manley McRae Jordan, MD

  • Pulmonary Disease Physician
  • Lake Charles, LA
  • NPI 1932118296
  NPD
• Lisa Lounsberry, PHARMD

  • Pharmacist
  • Lake Charles, LA
  • NPI 1659190361
  NPD
• Jody Olmsted Arnold, RPH

  • Pharmacist
  • Lake Charles, LA
  • NPI 1285149690
  NPD (past)

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1750446183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD STE 110",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018977",
            "telephone_number": "337-494-2990",
            "fax_number": "337-494-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD STE 110",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018977",
            "telephone_number": "337-494-2990",
            "fax_number": "337-494-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE CHARLES PHARMACEUTICAL SUPPLY COMPANY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST LOUISIANA HOSPITAL ASSOCIATION",
        "enumeration_date": "2006-12-26",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-28",
        "status": "A",
        "authorized_official_last_name": "SALTZMAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "JOINER",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "337-494-2990"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2133790",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2206842",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "007810-IR",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Plaza Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medical Plaza Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lake Charles Medical Services, Inc
• Lake Charles Medical Services, Inc
• Lake Charles Medical Services, Inc
• Lake Charles Medical Services, Inc
• Lake Charles Memorial Heart and Vascular Center
• Lake Charles Primary Care and Wellness
• Lake Charles Rheumatology LLC
• Lake Charles Senior Care Clinic LLC
• Lake Charles Sports & Rehab
• Lake Charles Urgent Care

• Community/Retail Pharmacy in Lake Charles, LA
• Providers in Lake Charles, 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 Apr 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.