Provider Demographics
NPI:1447596879
Name:ICARE CLINICAL CONSULTING LLC
Entity Type:Organization
Organization Name:ICARE CLINICAL CONSULTING LLC
Other - Org Name:ICARE CONSULTANT PHARMACIST, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:VEILLON
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:337-296-1384
Mailing Address - Street 1:2807 KALISTE SALOOM RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7141
Mailing Address - Country:US
Mailing Address - Phone:337-889-3170
Mailing Address - Fax:337-889-3172
Practice Address - Street 1:104 DARWIN CIR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7110
Practice Address - Country:US
Practice Address - Phone:337-296-1384
Practice Address - Fax:337-889-3172
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ICARE PHARMACY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-12-12
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy