Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 333600000X | Pharmacy | | 1320 IR | LOUISIANA | No |
| 2 | 3336H0001X | Pharmacy | Home Infusion Therapy Pharmacy | 1320 IR | LOUISIANA | No |
| 3 | 332BX2000X | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies | 1320 IR | LOUISIANA | No |
| 4 | 3336S0011X | Pharmacy | Specialty Pharmacy | 1320 IR | LOUISIANA | No |
| 5 | 3336M0002X | Pharmacy | Mail Order Pharmacy | 1320 IR | LOUISIANA | No |
| 6 | 3336C0003X | Pharmacy | Community/Retail Pharmacy | 1320 IR | LOUISIANA | No |
| 7 | 332BP3500X | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | 1320 IR | LOUISIANA | No |
| 8 | 3336L0003X | Pharmacy | Long Term Care Pharmacy | 1320 IR | LOUISIANA | No |
| 9 | 332BC3200X | Durable Medical Equipment & Medical Supplies | Customized Equipment | 1320 IR | LOUISIANA | No |
| 10 | 332B00000X | Durable Medical Equipment & Medical Supplies | | 1320 IR | LOUISIANA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 2200259 | MEDICAID | LOUISIANA | |