NPIMap

Organization Active NPI

Iberia Comprehensive CHC Pharmacy

  • Community/Retail Pharmacy
  • New Iberia, LA
National Provider Identifier
1881871333
Registry record updated Dec 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
5987 Issued in LA
Legal business name
IBERIA COMPREHENSIVE CHC PHARMACY
Doing business as
Iberia Comprehensive CHC Pharmacy
Practice address
806 Jefferson Ter
New Iberia, LA 70560-5727
Phone
(337) 376-6868
Fax
(337) 376-6866
NPI assigned
Jan 28, 2008
Last updated
Dec 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2021

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

Authorized official

Name
Reginald Boutte, RPHNPI 1114588373
Title
Pic
Phone
(337) 376-6868

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 5987 LA Primary

Addresses

Primary practice location

806 Jefferson Ter
New Iberia, LA 70560-5727

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 376-6868

Other identifiers 1

IdentifierTypeStateIssuer
2035620OtherPK

Other names 1

  • IBERIA COMPREHENSIVE CHC PHARMACY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
St Martin Parish CHC Pharmacy15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638316800000",
    "number": "1881871333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-376-6868",
            "fax_number": "337-376-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-376-6868",
            "fax_number": "337-376-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IBERIA COMPREHENSIVE CHC PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2021-12-01",
        "certification_date": "2021-12-01",
        "status": "A",
        "authorized_official_last_name": "BOUTTE",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "PIC",
        "authorized_official_telephone_number": "337-376-6868",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "5987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035620",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IBERIA COMPREHENSIVE CHC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; 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.