Active NPI
Khanh Mai
- Pharmacist
- Gonzales, LA
National Provider Identifier
1750714663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 018877
- Practice address
- 1624 N Burnside Ave
Gonzales, LA 70737-2139 - Phone
- (225) 644-7528
- NPI assigned
- Aug 14, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018877 | LA | Primary |
Addresses
Primary practice location
1624 N Burnside Ave
Gonzales, LA 70737-2139
Mailing address
4710 Old Oak Dr
Orange, TX 77632-1320
Phone (409) 338-2893
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018877 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376438400000",
"number": "1750714663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4710 OLD OAK DR",
"city": "ORANGE",
"state": "TX",
"postal_code": "776321320",
"telephone_number": "409-338-2893"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1624 N BURNSIDE AVE",
"city": "GONZALES",
"state": "LA",
"postal_code": "707372139",
"telephone_number": "225-644-7528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAI",
"first_name": "KHANH",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-14",
"last_updated": "2013-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "018877",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gonzales, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.