Ideal Health Mart

LBN: Ideal Health Mart Pharmacy Inc
Ideal Health Mart is an health care organization with primary practice located at 610 N Pine St , Deridder LA 70634-3546. The organization recently has only one registered license in Suppliers / Pharmacy, which is considered as the primary health care specialty. Ideal Health Mart Pharmacy Inc can be contacted via phone (337) 463-7210, or through Lane, Kesa via phone (337) 463-7210.

Contact Information

Primary practice address
610 N Pine St Deridder LA 70634-3546
Phone: (337) 463-7210
Fax: (337) 462-0930
Website:
Map and Directions
Authorized official contact:
Name: Lane, Kesa
Phone: (337) 463-7210

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 006477 Louisiana

Profile Details

NPI number 1568510030
LBN Legal business name Ideal Health Mart Pharmacy Inc
DBA Doing business as Ideal Health Mart
Authorized official Lane, Kesa
Entity Organization
Organization subpart 1 No
Enumeration date Jan 8th, 2007
Last updated May 16th, 2014 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568510030 NPPES
Other 1902801 NCPDP PROVIDER IDENTIFICATION NUMBER
MEDICAID 2201344 NCPDP PROVIDER IDENTIFICATION NUMBER

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