Provider Demographics
NPI:1942088455
Name:ARKLATEX APOTHECARY, LLC
Entity Type:Organization
Organization Name:ARKLATEX APOTHECARY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:BIBBEE
Authorized Official - Suffix:II
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:318-963-1165
Mailing Address - Street 1:PO BOX 664
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-0664
Mailing Address - Country:US
Mailing Address - Phone:318-963-1165
Mailing Address - Fax:
Practice Address - Street 1:100 SIBLEY ST
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006-8354
Practice Address - Country:US
Practice Address - Phone:318-963-1165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy