Organization
CCC PHARMACY LLC
Active
Other names
FUSIONCARE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN PAUL ROBICHAUX (MANAGER)
(318) 445-8770
Entity
Organization
Contact information
Practice address
180 WINDERMERE BLVD, ALEXANDRIA, LA 71303-3535
(318) 445-8770
(318) 445-8979
Mailing address
180 WINDERMERE BLVD, ALEXANDRIA, LA 71303-3535
(318) 445-8770
(318) 445-8979
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
PHY006277-IR
LA
3336L0003X
Long Term Care Pharmacy
PHY-0622IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2200216
—
LA
Enumeration date
12/16/2010
Last updated
01/20/2016
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