PINE PRAIRIE PHARMACY,INC — NPI 1366402364 (Licensed & Credentialed Pharmacist in PINE PRAIRIE, LA)

CMS-1500 Box 24J / 33a • NPI

1366402364

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

183500000X

Licensed & Credentialed Pharmacist

Box 32 Service Location & ZIP+4

10711 VETERANS MEMORIAL HWY, PINE PRAIRIE, LA, 70576

Official NPPES Practice Location

Practice Phone & Referral Fax

(337) 599-2050

Fax: (337) 599-2596

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1366402364 (PINE PRAIRIE PHARMACY,INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1366402364` (NPI-2 Organization / Facility)
Provider / Legal Name	PINE PRAIRIE PHARMACY,INC
Plain-English Specialty	Licensed & Credentialed Pharmacist NUCC Code: `183500000X` (Pharmacist)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	10711 VETERANS MEMORIAL HWY, PINE PRAIRIE, LA, 70576
Practice Telephone / Fax	Tel: (337) 599-2050 \| Fax: (337) 599-2596
Administrative Mailing Address	PO BOX 800, PINE PRAIRIE, LA, 70576-0800
Enumeration & Last Sync	Enumerated: 2006-03-24 \| CMS Record Updated: 2025-04-28
Authorized Official	BART ENICKE (president/pharmacist-in-charge)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10711 VETERANS MEMORIAL HWY, PINE PRAIRIE, LA, 70576

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Plain-English Taxonomy & CMS Crosswalk (183500000X)

What Does Taxonomy Code 183500000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 183500000X translates to:
"Licensed & Credentialed Pharmacist"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Pharmacist for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (PINE PRAIRIE PHARMACY,INC)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`183500000X` — Pharmacist Plain English: Licensed & Credentialed Pharmacist	State: LA \| License: `5075-ir` \| Primary: Yes (Primary)
`3336C0003X` — Pharmacy, Community/Retail Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary
`3336L0003X` — Pharmacy, Long Term Care Pharmacy Plain English: Licensed & Credentialed Suppliers — Pharmacy, Long-term Care Pharmacy	State: N/A \| License: `Verified` \| Primary: Secondary

Medical Billing, RCM & Hospital Credentialing Teams:

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PINE PRAIRIE PHARMACY,INC (NPI #1366402364)