Provider Demographics
NPI:1316917727
Name:HSP,LLC
Entity type:Organization
Organization Name:HSP,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:HOBBS
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:504-324-6270
Mailing Address - Street 1:PO BOX 6704
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-6704
Mailing Address - Country:US
Mailing Address - Phone:504-324-6270
Mailing Address - Fax:504-324-6273
Practice Address - Street 1:3600 GENERAL MEYER AVE
Practice Address - Street 2:SUITE C
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-3393
Practice Address - Country:US
Practice Address - Phone:504-324-6270
Practice Address - Fax:504-324-6273
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5313070001OtherMEDICARE PART B
LA1271098Medicaid
LA1271098Medicaid