LINE AVENUE PHARMACY INC NPI 1619058468

NPI Information

  • NPI: 1619058468
  • Provider Name: LINE AVENUE PHARMACY INC
  • Classification: Pharmacy - 3336N0007X
  • Specialization: Nuclear Pharmacy
  • Entity Type: Organization
  • :
  • Address: 1822 LINE AVE
    SHREVEPORT, LA
    ZIP 71101
  • Phone: (318) 221-5114

Map and Directions

Get Directions

NPI Details

LINE AVENUE PHARMACY INC is a nuclear pharmacy pharmacy in Shreveport, LA. The provider is a pharmacy dedicated to the compounding and dispensing of radioactive materials for use in nuclear imaging and nuclear medical procedures. LINE AVENUE PHARMACY INC NPI is 1619058468. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

1822 LINE AVE
SHREVEPORT, LA
ZIP 71101-612
Phone: (318) 221-5114
Fax: (318) 221-5137

The provider's authorized official is Stephen Randall Caudle .
The authorized official title is President/owner and has the following contact phone number (318) 221-5114.

The enumeration date for this NPI number is 10/18/2006 and was last updated on 9/11/2025.

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
13336C0003XPharmacyCommunity/Retail PharmacyLA 3999-IRLOUISIANANo
23336N0007XPharmacyNuclear PharmacyLA 4001-NULOUISIANAYes

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
11266841MEDICAIDLOUISIANA

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI