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Contact Information

KELLY PHARMACY INC KELLY PHARMACY & GIFTS
302 E PALMETTO
PLAIN DEALING, LA71064
 Phone: 318-326-4229
 Fax: 318-326-5903
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Long Term Care Pharmacy

3336L0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for KELLY PHARMACY INC KELLY PHARMACY & GIFTS

NPI Number 1760576011
LBN Legal business name KELLY PHARMACY INC KELLY PHARMACY & GIFTS
Authorized official PATRICK BOGGS - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 10/03/2006
Last updated 10/27/2020 - About 6 years ago
Identifiers
LA License # PHY.002188-IR
AR Medicaid 121851407
LA Medicaid 1258105
Other 2029118 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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