Johns Pharmacy in Albany LLC
Organization Active NPI Community/Retail Pharmacy · Albany, LA
NPI 1912178294 · NPPES record last updated Dec 1, 2021
Key facts
- NPI
- 1912178294
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- PHY.005954-IR (LA)
- Legal business name
- JOHNS PHARMACY IN ALBANY LLC
- Practice address
- 29148 South Montpelier Ave
Albany, LA 70711 - Phone
- (225) 567-1921
- Fax
- (225) 567-1931
- NPI assigned
- Mar 14, 2008
- Organization subpart
- No
Authorized official
- Name
- John Smith, RPH
- Title
- Owner
- Phone
- (985) 320-3518
Practitioners 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200826000788 | LA | Part B Supplier - Mass Immunization (Roster Biller Only) | 8820247992 | Practice locations: Albany, LA |
| O20220412001021 | LA | Part B Supplier - Independent Clinical Laboratory | 8820247992 | Practice locations: Albany, LA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | PHY.005954-IR | LA | Yes |
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
29148 South Montpelier Ave
Albany, LA 70711
Mailing address
PO Box 328
Albany, LA 70711-0328
Phone (225) 567-1921
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2035610 | Other | PK | |
| 1223409 | Medicaid | LA |
Other names
- JOHN'S PHARMACY
Other providers in Albany, LA
- Abby Claire Harper
- David Michael Hebert
- Jacquelynn Hebert
- Kaitlin Loupe Hebert
- Johns Pharmacy in Albany LLC
- Desmond Knighton
- Sugcora Knighton
- Anthony Lamarca
- Jan Matherne Lantrip
- Derrek Leonard Mart
All providers in Albany, LA · Community/Retail Pharmacy in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.