Provider Demographics
NPI:1902838949
Name:SPRINGHILL FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:SPRINGHILL FAMILY PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-259-7334
Mailing Address - Street 1:1190 S ARKANSAS ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGHILL
Mailing Address - State:LA
Mailing Address - Zip Code:71075-3824
Mailing Address - Country:US
Mailing Address - Phone:318-539-3258
Mailing Address - Fax:318-539-3320
Practice Address - Street 1:1190 S ARKANSAS STREET
Practice Address - Street 2:
Practice Address - City:SPRINGHILL
Practice Address - State:LA
Practice Address - Zip Code:71075
Practice Address - Country:US
Practice Address - Phone:318-539-3451
Practice Address - Fax:318-539-9230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0003X
LA28893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1925253OtherNCPDP
LA1261505Medicaid
1925253OtherOTHER ID NUMBER-COMMERCIAL NUMBER
0537670009Medicare NSC