Provider Demographics
NPI:1295849271
Name:CADES PHARMACY LLC
Entity Type:Organization
Organization Name:CADES PHARMACY LLC
Other - Org Name:CADE'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PIC
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIENNE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:318-354-0501
Mailing Address - Street 1:1053 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6276
Mailing Address - Country:US
Mailing Address - Phone:318-354-0501
Mailing Address - Fax:318-354-9590
Practice Address - Street 1:1053 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6276
Practice Address - Country:US
Practice Address - Phone:318-354-0501
Practice Address - Fax:318-354-9590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
LAPHY004200IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1266931Medicaid
2034394OtherPK