Line Avenue Pharmacy Inc
NPI 1619058468ActiveOrganization· Pharmacy, Nuclear Pharmacy· Shreveport, LA
Pharmacy, Nuclear Pharmacy in Shreveport, Louisiana, registered in NPPES in October 2006. The authorized official on file is Stephen Randall Caudle, PD, President/Owner.
Overview
| NPI | 1619058468 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 18, 2006 |
| Last updated in NPPES | Sep 11, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy, Nuclear Pharmacy Primary | 3336N0007X | LA 4001-NU | LA |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | LA 3999-IR | LA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Pharmacy, Nuclear Pharmacy providers in Shreveport
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