Provider Demographics
NPI:1174708127
Name:BIOPLUS SPECIALTY PHARMACY LA, LLC
Entity type:Organization
Organization Name:BIOPLUS SPECIALTY PHARMACY LA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:855-733-3126
Mailing Address - Street 1:2731 MANHATTAN BLVD
Mailing Address - Street 2:STE B17
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058
Mailing Address - Country:US
Mailing Address - Phone:504-355-4191
Mailing Address - Fax:504-355-4192
Practice Address - Street 1:2731 MANHATTAN BLVD
Practice Address - Street 2:STE B17
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-6151
Practice Address - Country:US
Practice Address - Phone:504-355-4191
Practice Address - Fax:504-355-4192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X
LAPHY.006884-IR3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600053902Medicaid
TNQ035630Medicaid
NJ0643670Medicaid
KS201121390AMedicaid
OH0171008Medicaid
AL214213Medicaid
LA2202669Medicaid
GA003131098AMedicaid
CO71680063Medicaid
AR198294407Medicaid
IN201309380AMedicaid
2145940OtherPK
KY7100266960Medicaid
MD198005000Medicaid
OK200340250AMedicaid
FL011924800Medicaid
IA0218110Medicaid
MS08531821Medicaid
AZ093928Medicaid
PA103142281-0001Medicaid
NM56970501Medicaid