Gina Dimattia, PHARMD
Individual provider Active NPI Pharmacist · Walker, LA
NPI 1831473503 · NPPES record last updated Sep 29, 2011
Key facts
- NPI
- 1831473503
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 018306 (LA)
- Practice address
- 29881 Walker South Rd
Walker, LA 70785 - Phone
- (225) 665-4580
- NPI assigned
- Sep 29, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018306 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients | |
| Louisiana CVS Pharmacy, L.L.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 018306 | LA | Yes |
Addresses
Primary practice location
29881 Walker South Rd
Walker, LA 70785
Mailing address
PO Box 1448
Walker, LA 70785-1448
Phone (225) 665-4580
Other providers in Walker, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 29, 2011. 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.