<Unavail>

LBN: Line Avenue Pharmacy Inc
<Unavail> 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 / Nuclear 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:
Map and Directions
Authorized official contact:
Name: Caudle, Stephen Randall PD
Phone: (318) 221-5114

Health care specialties

SpecialtyCodeLicense #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 <Unavail>
Authorized official Caudle, Stephen Randall PD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 18th, 2006
Last updated Sep 11th, 2025 - about last year

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 1619058468 NPPES
Louisiana MEDICAID 1266841

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