Shreveport Nuclear Pharmacy
LBN: Line Avenue Pharmacy Inc
Shreveport Nuclear Pharmacy is an health care organization with primary practice located at 1822 Line Ave , Shreveport LA 71101-4612. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Nuclear Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Line Avenue Pharmacy Inc can be contacted via phone (318) 221-5114, or through Caudle, Stephen Randall via phone (318) 221-5114.
Contact Information
Primary practice address
1822 Line Ave
Shreveport LA 71101-4612
Phone: (318) 221-5114
Fax: (318) 221-5137
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | LA 3999-IR | Louisiana |
| Suppliers / Nuclear Pharmacy | 3336N0007X | LA 4001-NU | Louisiana |
Profile Details
| NPI number | 1619058468 |
|---|---|
| LBN Legal business name | Line Avenue Pharmacy Inc |
| DBA Doing business as | Shreveport Nuclear Pharmacy |
| Authorized official | Caudle, Stephen Randall PD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Aug 22nd, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619058468 | NPPES |
| Louisiana | MEDICAID | 1266841 |
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