National Provider Identifier Database

LIL BOOS CORNER STORE LLC
Community/Retail Pharmacy

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.


Contact Information

LIL BOOS CORNER STORE LLC
415 ST. CLAIR RD. STE. C
BOYCE, LA71409
Phone: 318-793-2028
Fax: 859-594-6639
Website:
Specialty Taxonomy Code
* Community/Retail Pharmacy 3336C0003X
Pharmacy 333600000X

* Indicates primary specialty

NPI Profile & details for LIL BOOS CORNER STORE LLC

NPI Number 1639619653
Legal business name
LBN
LIL BOOS CORNER STORE LLC
Authorized official ROBERT MADDOX IV - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 02/24/2017
Last updated 07/18/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • LA License #: PHY.007439-IR
  • LA Medicaid: 2204980
  • Other: 2168053 PK

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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