Provider Demographics
NPI:1770653156
Name:PHILIP'S FAMILY PHARMACY
Entity Type:Organization
Organization Name:PHILIP'S FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:CASH
Authorized Official - Suffix:II
Authorized Official - Credentials:PD
Authorized Official - Phone:318-878-3671
Mailing Address - Street 1:203 DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2819
Mailing Address - Country:US
Mailing Address - Phone:318-878-3671
Mailing Address - Fax:318-878-8500
Practice Address - Street 1:203 DEPOT ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2819
Practice Address - Country:US
Practice Address - Phone:318-878-3671
Practice Address - Fax:318-878-8500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2276 IR3336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1258849Medicaid
LA0435610001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER