National Provider Identifier Database

LINE AVENUE PHARMACY INC
Nuclear Pharmacy

A pharmacy dedicated to the compounding and dispensing of radioactive materials for use in nuclear imaging and nuclear medical procedures.


Contact Information

LINE AVENUE PHARMACY INC
1822 LINE AVE
SHREVEPORT, LA71101-4612
Phone: 318-221-5114
Fax: 318-221-5137
Website:
Specialty Taxonomy Code
* Nuclear Pharmacy 3336N0007X
Community/Retail Pharmacy 3336C0003X

* Indicates primary specialty

NPI Profile & details for LINE AVENUE PHARMACY INC

NPI Number 1619058468
Legal business name
LBN
LINE AVENUE PHARMACY INC
Authorized official STEPHEN CAUDLE - (PRESIDENT/OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/18/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor1 Not specified
Identifiers
  • LA License #: LA 3999-IR
  • LA License #: LA 4001-NU
  • LA Medicaid: 1266841

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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