Provider Demographics
NPI:1477912558
Name:DONS PHARMACY LLC
Entity Type:Organization
Organization Name:DONS PHARMACY LLC
Other - Org Name:DON'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:SERPAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-516-2706
Mailing Address - Street 1:316 TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7244
Mailing Address - Country:US
Mailing Address - Phone:504-439-9883
Mailing Address - Fax:504-603-2966
Practice Address - Street 1:2201 PARIS RD
Practice Address - Street 2:SUITES E AND F
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-5000
Practice Address - Country:US
Practice Address - Phone:504-516-2706
Practice Address - Fax:504-603-2966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-17
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X
LAPHY007304IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2204645Medicaid
2158185OtherPK