Intrathecal Compounding Specialists LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

5856 Issued in LA

Legal business name

INTRATHECAL COMPOUNDING SPECIALISTS LLC

Practice address

206 A Jacobs Run
Scott, LA 70583

Phone

(337) 237-6077

Fax

(337) 237-8841

NPI assigned

Feb 19, 2008

Organization subpart

No

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

Authorized official

Name

Stuart Burgess, RPH

Title

Dir of Pharmacy

Phone

(337) 237-6077

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• INTRATHECAL COMPOUNDING SPECIALISTS LLC Doing business as

Locations

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1952579484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 A JACOBS RUN",
            "city": "SCOTT",
            "state": "LA",
            "postal_code": "70583",
            "telephone_number": "337-237-6077",
            "fax_number": "337-237-8841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 A JACOBS RUN",
            "city": "SCOTT",
            "state": "LA",
            "postal_code": "70583",
            "telephone_number": "337-237-6077",
            "fax_number": "337-237-8841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTRATHECAL COMPOUNDING SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "DIR OF PHARMACY",
        "authorized_official_telephone_number": "337-237-6077",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "LA",
            "license": "5856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035607",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "INTRATHECAL COMPOUNDING SPECIALISTS LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Michael Hollier, DC
• Julesa Maree Howard, MHS
• Barbara Hunter
• Valentini Imvriotis, P.T.
• Institutional Pharmacies of Louisiana L L C
• J&J'S Caring Transportation, LLC
• Alaia Jackson
• Kortney Jacobsen, NURSE PRACTITIONER
• Alonda Jenkins
• Chad Jimenez, PT, DPT

• All providers in Scott, LA
• Compounding Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.