Lil Boos Corner Store LLC
Lil Boos Corner Store LLC is a healthcare organization registered as Community/Retail Pharmacy in Boyce, LA, holding Type 2 (organization) NPI 1639619653 since 2017. The authorized official on file is Robert Maddox IV, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1639619653 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Lil Boos Corner Store LLC |
| Other name | <Unavail> |
| Practice address | 415 ST. CLAIR RD. STE. C, Boyce, LA, 71409 |
| Phone | 3187932028 |
| Fax | 8595946639 |
| Enumeration date | 2017-02-24 |
| Last updated in NPPES | 2023-07-18 |
Authorized official
| Name | Robert Maddox IV |
|---|---|
| Title | Owner |
| Phone | 3187932028 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 333600000X | Pharmacy | Secondary | — | — |
| 3336C0003X | Community/Retail Pharmacy | Primary | PHY.007439-IR | LA |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2204980 | Medicaid | LA | — |
| 2168053 | Other | — | PK |
Copy-ready billing details
Provider: Lil Boos Corner Store LLC NPI: 1639619653 Taxonomy: 3336C0003X (Community/Retail Pharmacy) Address: 415 ST. CLAIR RD. STE. C, Boyce, LA, 71409
Verify this record
Cross-check NPI 1639619653 against the authoritative CMS record: view Lil Boos Corner Store LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
How current is this record?
Where is Lil Boos Corner Store LLC located?
Source: CMS NPPES (public data). Snapshot 2026-07-10. Provider record last updated 2023-07-18.