Provider Demographics
NPI:1932615820
Name:PARKERS PHARMACY LLC
Entity Type:Organization
Organization Name:PARKERS PHARMACY LLC
Other - Org Name:PARKER'S PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-960-2444
Mailing Address - Street 1:9600 FLORIDA BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70815-1110
Mailing Address - Country:US
Mailing Address - Phone:225-960-2444
Mailing Address - Fax:225-960-2655
Practice Address - Street 1:9600 FLORIDA BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70815-1110
Practice Address - Country:US
Practice Address - Phone:225-960-2444
Practice Address - Fax:225-960-2655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-14
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.007561-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175026OtherPK
LA2205528Medicaid