Active NPI
Natasha Pham
- Pharmacist
- Bossier City, LA
National Provider Identifier
1972100469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.023589
- Practice address
- 3400 Airline Dr
Bossier City, LA 71111-2122 - Phone
- (318) 741-6589
- NPI assigned
- Oct 7, 2020
- Sex
- Female
- Sole proprietor
- No
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.023589 | LA | Primary |
Addresses
Primary practice location
3400 Airline Dr
Bossier City, LA 71111-2122
Mailing address
300 Bayou Trace Dr
Monroe, LA 71203-6121
Other practice location 1
9209 Mansfield Rd
Shreveport, LA 71118-3152
Phone (318) 671-0271
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PST.023589 | Other | LA | PHARMACIST LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.023589 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Louisiana Co Inc | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Louisiana Co Inc | Past | Accepting new patients |
Locations
3400 Airline Dr
Bossier City, LA 71111
Phone (318) 741-6589
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1972100469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 BAYOU TRACE DR",
"city": "MONROE",
"state": "LA",
"postal_code": "712036121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 AIRLINE DR",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711112122",
"telephone_number": "318-741-6589"
}
],
"practiceLocations": [
{
"address_1": "9209 Mansfield Rd",
"address_purpose": "LOCATION",
"city": "Shreveport",
"state": "LA",
"postal_code": "711183152",
"country_code": "US",
"telephone_number": "318-671-0271",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHAM",
"first_name": "NATASHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-07",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.023589",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "PST.023589",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.