Provider Demographics
NPI:1558471482
Name:C AND C PHARMACY LLC
Entity Type:Organization
Organization Name:C AND C PHARMACY LLC
Other - Org Name:C AND C DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:VALLEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:985-626-0234
Mailing Address - Street 1:7540 W JUDGE PEREZ DR
Mailing Address - Street 2:
Mailing Address - City:ARABI
Mailing Address - State:LA
Mailing Address - Zip Code:70032-1915
Mailing Address - Country:US
Mailing Address - Phone:504-279-0446
Mailing Address - Fax:504-278-2388
Practice Address - Street 1:7540 W. JUDGE PEREZ DR.
Practice Address - Street 2:
Practice Address - City:ARABI
Practice Address - State:LA
Practice Address - Zip Code:70032-1915
Practice Address - Country:US
Practice Address - Phone:504-279-0446
Practice Address - Fax:504-278-2388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LA56373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1932753OtherOTHER ID NUMBER
LA1233811Medicaid
LA1233811Medicaid