Active NPI
Logan Prudhomme, PHARMD
- Pharmacist
- Jonesboro, LA
National Provider Identifier
1831826668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.024410
- Practice address
- 184 Old Winnfield Rd
Jonesboro, LA 71251-5902 - Phone
- (318) 259-6694
- NPI assigned
- Aug 2, 2022
- Sex
- Male
- 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 | PST.024410 | LA | Primary |
Addresses
Primary practice location
184 Old Winnfield Rd
Jonesboro, LA 71251-5902
Mailing address
184 Old Winnfield Rd
Jonesboro, LA 71251-5902
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | l0p0839.s00023.us@wal-mart.com |
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.024410 | LA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1831826668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "184 OLD WINNFIELD RD",
"city": "JONESBORO",
"state": "LA",
"postal_code": "712515902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 OLD WINNFIELD RD",
"city": "JONESBORO",
"state": "LA",
"postal_code": "712515902",
"telephone_number": "318-259-6694"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRUDHOMME",
"first_name": "LOGAN",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-02",
"last_updated": "2022-08-02",
"certification_date": "2022-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.024410",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "l0p0839.s00023.us@wal-mart.com",
"affiliation": "N",
"address_1": "184 Old Winnfield Rd",
"city": "Jonesboro",
"state": "LA",
"country_code": "US",
"postal_code": "712515902",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Jonesboro, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.