MEDIC PHARMACY OF BASTROP NPI 1205815800

NPI Information

NPI: 1205815800
Provider Name: MEDIC PHARMACY OF BASTROP
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
1821 N WASHINGTON ST
BASTROP, LA
ZIP 71220
Phone: (318) 281-3291
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MEDIC PHARMACY OF BASTROP is a customized equipment durable medical equipment medical supplies in Bastrop, LA. MEDIC PHARMACY OF BASTROP NPI is 1205815800. The provider is registered as an organization entity type.

The provider's business location address is:

1821 N WASHINGTON ST
BASTROP, LA
ZIP 71220-441
Phone: (318) 281-3291
Fax: (318) 281-3292

The provider's authorized official is William Gary Grayson .
The authorized official title is Owner/president/pharmacist and has the following contact phone number (318) 281-3291.

The enumeration date for this NPI number is 1/11/2006 and was last updated on 8/22/2020.

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	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment	0304220001	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	1903649	OTHER	LOUISIANA	NAPB
2	C5068	OTHER	LOUISIANA	BLUE CROSS BLUE SHIELD OF
3	1533611	MEDICAID	LOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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