1215237557 NPI number — MRS. MONICA MAYFIELD ARMSTRONG MONICA MARKEY

Table of content: MRS. MONICA MAYFIELD ARMSTRONG MONICA MARKEY (NPI 1215237557)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215237557 NPI number — MRS. MONICA MAYFIELD ARMSTRONG MONICA MARKEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARMSTRONG
Provider First Name:
MONICA
Provider Middle Name:
MAYFIELD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MONICA MARKEY
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MARKEY
Provider Other First Name:
MONICA
Provider Other Middle Name:
MAYFIELD
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1215237557
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10200 FLORIDA BLVD WALGREENS 11762
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALLER
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70785
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
225-664-5181
Provider Business Mailing Address Fax Number:
225-664-5859

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3081 S. RANGE AVE WALGREENS 13080
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENHAM SPRINGS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70726
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-664-8094
Provider Business Practice Location Address Fax Number:
225-664-8496
Provider Enumeration Date:
11/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  17317 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 183500000X , with the licence number: T-010112 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2350633 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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