Provider Demographics
NPI:1265983126
Name:B S PHARMACY LLC
Entity type:Organization
Organization Name:B S PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:GOMILA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:985-643-7894
Mailing Address - Street 1:999 ROBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2009
Mailing Address - Country:US
Mailing Address - Phone:985-643-7894
Mailing Address - Fax:985-649-2183
Practice Address - Street 1:999 ROBERT BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2009
Practice Address - Country:US
Practice Address - Phone:985-643-7894
Practice Address - Fax:985-649-2183
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:B S PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA71593104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness