Provider Demographics
NPI:1124567516
Name:NORTH LOUISIANA INSTITUTIONAL PHARMACY LLC
Entity Type:Organization
Organization Name:NORTH LOUISIANA INSTITUTIONAL PHARMACY LLC
Other - Org Name:PILLS IN A POUCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-445-6470
Mailing Address - Street 1:405 BIENVILLE ST STE B
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5746
Mailing Address - Country:US
Mailing Address - Phone:318-357-7665
Mailing Address - Fax:318-352-1881
Practice Address - Street 1:405 BIENVILLE ST STE B
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-5746
Practice Address - Country:US
Practice Address - Phone:318-357-7665
Practice Address - Fax:318-352-1881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-17
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.007475-IR3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2205251Medicaid
2168532OtherPK