Provider Demographics
NPI:1982837365
Name:PARTNERS PHARMACY LLC
Entity Type:Organization
Organization Name:PARTNERS PHARMACY LLC
Other - Org Name:PARTNERS PHARMACY, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:DELRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-284-0255
Mailing Address - Street 1:3915 KIRKMAN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-3503
Mailing Address - Country:US
Mailing Address - Phone:337-214-0420
Mailing Address - Fax:337-312-1785
Practice Address - Street 1:3915 KIRKMAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-3503
Practice Address - Country:US
Practice Address - Phone:337-214-0420
Practice Address - Fax:337-312-1785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-01
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LA62053336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1235431Medicaid
2122787OtherPK