MEDIC PHARMACY OF BASTROP; NPI #1205815800

Contact Information

MEDIC PHARMACY OF BASTROP

1821 N WASHINGTON ST
BASTROP, LA 71220-2441

Phone: 318-281-3291
Fax: 318-281-3292
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Customized Equipment	332BC3200X	87	All Other Suppliers

Indicates primary specialty

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NPI Profile & details for MEDIC PHARMACY OF BASTROP

NPI # 1205815800

LBN Legal business name MEDIC PHARMACY OF BASTROP

Authorized official WILLIAM GRAYSON - (OWNER/PRESIDENT/PHARMACIST)

Entity Organization

Organization subpart ¹ No

Enumeration date 01/11/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

LA	License #	0304220001
LA	Medicaid	1533611
LA	Other	C5068	BLUE CROSS BLUE SHIELD OF
LA	Other	1903649	NAPB

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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