Provider Demographics
NPI:1174632160
Name:CARR DRUGS
Entity Type:Organization
Organization Name:CARR DRUGS
Other - Org Name:CARR DRUGS #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:504-366-1200
Mailing Address - Street 1:17A WESTSIDE SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-3640
Mailing Address - Country:US
Mailing Address - Phone:504-366-1200
Mailing Address - Fax:
Practice Address - Street 1:17A WESTSIDE SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-3640
Practice Address - Country:US
Practice Address - Phone:504-366-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARR DRUGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-30
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA24073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1259608Medicaid
LA1924249OtherNCPDP