Provider Demographics
NPI:1902296478
Name:UNION CARE PHARMACY, LLC
Entity Type:Organization
Organization Name:UNION CARE PHARMACY, LLC
Other - Org Name:VITAL CARE OF HOUMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THANH
Authorized Official - Middle Name:V
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-606-8747
Mailing Address - Street 1:304 CORPORATE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2458
Mailing Address - Country:US
Mailing Address - Phone:985-262-8214
Mailing Address - Fax:985-346-3648
Practice Address - Street 1:304 CORPORATE DR
Practice Address - Street 2:SUITE A
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2458
Practice Address - Country:US
Practice Address - Phone:985-262-8214
Practice Address - Fax:985-246-3648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-04
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPHY.007124-IR332B00000X, 332BP3500X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA7436350001Medicare NSC