SS Baton Rouge LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5449RC Issued in LA

Legal business name

SS BATON ROUGE LLC

Doing business as

QVL Pharmacy #222

Practice address

5454 Bluebonnet Rd
Ste H
Baton Rouge, LA 70809-2986

Phone

(225) 767-6329

Fax

(225) 767-8726

NPI assigned

May 17, 2006

Last updated

Jun 17, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gary Chad Collins

Title

Ceo

Phone

(214) 624-3050

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• QVL PHARMACY #222 Doing business as

Locations

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1912950536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803493",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753803493",
            "telephone_number": "214-624-3073",
            "fax_number": "214-989-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5454 BLUEBONNET RD",
            "address_2": "STE H",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708092986",
            "telephone_number": "225-767-6329",
            "fax_number": "225-767-8726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SS BATON ROUGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "GARY CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-624-3050"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "5449RC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1274542",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035022",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QVL PHARMACY #222",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Andrew Spustek, III III, PA-C
• Spyrie D Mays MD Apmc
• Kimberly Denise Square-James
• Brooklyn Marie Squiers, MD
• Sr Transportation
• Phyllis St Amant Jackson
• Chet St Amant, CRNA
• St Gabriel Health Clinic Inc (Gardere Center for Primary Care)
• St Luke House
• St Luke's Medical Group of Louisiana, LLC (St. Luke's Healthcare)

• Community/Retail Pharmacy in Baton Rouge, LA
• Providers in Baton Rouge, 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 Jun 17, 2014; 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.