Organization
ADVANCED SPECIALTY PHARMACY
Active
Organization
ADVANCED SPECIALTY PHARMACY
Active
Other names
ADVANCED SPECIALTY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY DAUZAT RPH (PHARMACY MANGER)
(337) 264-0301
Entity
Organization
Contact information
Practice address
719 COOLIDGE ST, LAFAYETTE, LA 70503-2309
(337) 264-0301
(337) 264-0307
Mailing address
719 COOLIDGE ST, LAFAYETTE, LA 70503-2309
(337) 264-0301
(337) 264-0307
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
5601
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932741
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/13/2006
Last updated
08/06/2009
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