Cottonport Corner Drug Llc

LBN: Cottonport Corner Drug Llc
Cottonport Corner Drug Llc is an health care organization with primary practice located at 206 Choupique Ln , Cottonport LA 71327-3757. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Cottonport Corner Drug Llc can be contacted via phone (318) 876-3665, or through Wixson, Kim via phone (318) 253-2399.

Contact Information

Primary practice address
206 Choupique Ln Cottonport LA 71327-3757
Phone: (318) 876-3665
Fax: (318) 876-2429
Website:
Map and Directions
Authorized official contact:
Name: Wixson, Kim
Phone: (318) 253-2399

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY.006498-IR Louisiana

Profile Details

NPI number 1922372358
LBN Legal business name Cottonport Corner Drug Llc
DBA Doing business as Cottonport Corner Drug Llc
Authorized official Wixson, Kim
Entity Organization
Organization subpart 1 No
Enumeration date Mar 2nd, 2012
Last updated Apr 13th, 2017 - about 9 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 1922372358 NPPES
Other 2134437 PK
MEDICAID 2201336 PK

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