Provider Demographics
NPI:1447706700
Name:MEDICINE BIN PLUS LLC
Entity type:Organization
Organization Name:MEDICINE BIN PLUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LASHUNDA
Authorized Official - Middle Name:ROSETTE
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:337-351-0822
Mailing Address - Street 1:412 AZELINE DR
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-9202
Mailing Address - Country:US
Mailing Address - Phone:337-408-8800
Mailing Address - Fax:337-408-8822
Practice Address - Street 1:1105 WEST WILLOW ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501
Practice Address - Country:US
Practice Address - Phone:337-408-8800
Practice Address - Fax:337-408-8822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-28
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2204734Medicaid