Deep South Medical Supply, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

DEEP SOUTH MEDICAL SUPPLY, LLC

Practice address

311 Chisum St
Sicily Island, LA 71368-4807

Phone

(318) 389-5807

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

John Bannister

Title

Manager

Phone

(318) 927-3523

Specialties & licenses 4

Addresses

Other identifiers 1

Tax ID family

Deep South Medical Supply LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Island Drug and Wellness, LLC

  • Community/Retail Pharmacy
  • Sicily Island, LA
  • NPI 1548866429
  NPD tax ID

Locations

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607299200000",
    "number": "1801356621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38",
            "city": "SICILY ISLAND",
            "state": "LA",
            "postal_code": "713680038",
            "telephone_number": "318-389-5807",
            "fax_number": "318-389-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 CHISUM ST",
            "city": "SICILY ISLAND",
            "state": "LA",
            "postal_code": "713684807",
            "telephone_number": "318-389-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP SOUTH MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A",
        "authorized_official_last_name": "BANNISTER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "318-927-3523"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207385",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catahoula Parish Hospital No. 2 (Harrisonburg Family Health)
• Angie W. Caylor, M. A., CCC-SLP
• Closing the Gap, L.L.C.
• Jacob Victor Crawford, FNP
• D.C. Lamarr Contracting LLC
• Summer Leigh Greer, NP-C
• Frances Hester, DR
• Island Drug and Wellness, LLC
• Island Institutional Pharmacy
• Island Pharmacy

• Community/Retail Pharmacy in Sicily Island, LA
• Providers in Sicily Island, 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 Dec 7, 2020; 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.