Provider Demographics
NPI:1821393653
Name:CMAP EXPRESS PHARMACY
Entity Type:Organization
Organization Name:CMAP EXPRESS PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:318-484-2773
Mailing Address - Street 1:929 JOHNSTON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-7638
Mailing Address - Country:US
Mailing Address - Phone:318-484-2773
Mailing Address - Fax:318-484-2775
Practice Address - Street 1:929 JOHNSTON ST
Practice Address - Street 2:SUITE B
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-7638
Practice Address - Country:US
Practice Address - Phone:318-484-2773
Practice Address - Fax:318-484-2775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5667-CH333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy