Organization
GULF STATES HEALTH PARTNERS LLC
Active
Other names
RX 2 GEAUX
Organization subpart
No
Provider details
NPI number
Authorized official
NIZAR ALIKHAN (CREDENTIALING CONTACT,AO)
(215) 888-8099
Entity
Organization
Contact information
Practice address
7855 HOWELL BLVD STE 160, BATON ROUGE, LA 70807-5257
(855) 360-1446
(888) 489-3558
Mailing address
5710 LBJ FWY, SUITE 325, DALLAS, TX 75240-6324
(214) 888-8099
(214) 261-2217
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.007095-IR
LA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146165
PK
—
Enumeration date
06/05/2014
Last updated
01/19/2017
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