Provider Demographics
NPI:1063808624
Name:NATIONAL PHARMACY ACQUISITION LLC
Entity type:Organization
Organization Name:NATIONAL PHARMACY ACQUISITION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEBOUEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-766-7828
Mailing Address - Street 1:5344 BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4344
Mailing Address - Country:US
Mailing Address - Phone:225-766-7828
Mailing Address - Fax:225-612-6802
Practice Address - Street 1:3202 W METAIRIE AVE S
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5235
Practice Address - Country:US
Practice Address - Phone:504-832-0614
Practice Address - Fax:504-836-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.007092-IR3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2151326OtherPK
LA2203649Medicaid