Provider Demographics
NPI:1487719811
Name:HEALTHSCRIPTS OF AMERICA-CENTRAL LOUISIANA LLC
Entity type:Organization
Organization Name:HEALTHSCRIPTS OF AMERICA-CENTRAL LOUISIANA LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEZAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-770-8194
Mailing Address - Street 1:1100 JACKSON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3320
Mailing Address - Country:US
Mailing Address - Phone:832-917-4931
Mailing Address - Fax:713-599-3696
Practice Address - Street 1:100 WESTLAND PL
Practice Address - Street 2:STE C
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-5446
Practice Address - Country:US
Practice Address - Phone:318-741-7163
Practice Address - Fax:318-388-4679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
LAPHY.006920-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2146949OtherPK
1929845OtherNCPDP PROVIDER IDENTIFICATION NUMBER