MANDEVILLE PHARMACY LLC
NPI: 1548616998
· MANDEVILLE, LA 70448
· Pharmacy
· NPI assigned 05/04/2016
$0.00
Total Medicaid Paid
Provider Details
| Authorized Official | ARMSTRONG, MALCOLM (PRESIDENT/PHARMACY MGR.) |
| NPI Enumeration Date | 05/04/2016 |
Monthly Spending Trend
Yearly Breakdown
| Year | Claims | Total Paid |
|---|
| 2021 |
129 |
$0.00 |
Billing Codes
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0013A |
|
32 |
32 |
$0.00 |
| 0012A |
|
44 |
43 |
$0.00 |
| 0011A |
|
53 |
53 |
$0.00 |