Innis Community Health Center, INC
Pharmacy, Community/Retail Pharmacy in Maringouin, LA. Organization (NPI-2).
NPI number1104720069
StatusActive
Last updated in NPPESOct 5, 2026
Details
- NPI
- 1104720069
- Entity type
- Organization (NPI-2)
- Legal business name
- Innis Community Health Center, INC
- Organization subpart
- Yes
- Enumeration date
- Oct 5, 2026
- Certification date
- Oct 5, 2026
- Last updated
- Oct 5, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | – | – | Yes |
| 261QF0400X | Clinic/Center, Federally Qualified Health Center (FQHC) | – | – | |
| 333600000X | Pharmacy | – | – |
Other names
- Arbor Family Pharmacy - Maringouin (Doing Business As)
Practice location
77575 Landry DrMaringouin, LA 70757-3210
Phone 225-618-5015 · Fax 225-442-3107
Mailing address
1620 W Northwest Hwy Ste 100Grapevine, TX 76051-3219
Phone 817-572-0009 · Fax 817-720-1039
Authorized official
Tomi Leonard
Cfo
2256187132
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