SS Bossier City LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5538IR Issued in LA

Legal business name

SS BOSSIER CITY LLC

Practice address

3501 Severn Ave Ste 3a
Ste 3a
Metairie, LA 70002-3459

Phone

(504) 889-8483

Fax

(504) 889-8487

NPI assigned

May 17, 2006

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 1

Addresses

Other identifiers 2

Other names 1

• QVL PHARMACY Doing business as

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": "1992758536",
    "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": "3501 SEVERN AVE STE 3A",
            "address_2": "STE 3A",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023459",
            "telephone_number": "504-889-8483",
            "fax_number": "504-889-8487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SS BOSSIER CITY 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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "5538IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1274992",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2035273",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QVL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Metairie, LA
• Providers in Metairie, 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.