Provider Demographics
NPI:1700773389
Name:ACADIANA PRACTITIONERS LLC
Entity type:Organization
Organization Name:ACADIANA PRACTITIONERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-447-4027
Mailing Address - Street 1:1119 PRUDHOMME CIR
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-6516
Mailing Address - Country:US
Mailing Address - Phone:337-447-4027
Mailing Address - Fax:
Practice Address - Street 1:1200 HOSPITAL DR STE 1
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6552
Practice Address - Country:US
Practice Address - Phone:337-284-5084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACADIANA PRACTITIONERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPHY009002IROtherLOUISIANA BOARD OF PHARMACY