OrganizationActiveAccepts Medicare
Kilgore Pharmacy LLC
NPI 1972202067 · Community/Retail Pharmacy · Haynesville, LA
Enrolled with Medicare as Part B Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1972202067
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Oluwafemi Adegboyega, Owner(708) 945-0269
Specialties & taxonomies
Suppliers
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1909 Main St
Haynesville, LA 71038-4907
Phone: (318) 624-1122
Fax: (318) 624-3343
Street-level locationGet directions
Mailing address
1909 Main St
Haynesville, LA 71038-4907
Other names (DBA / former)
- Doing business as
- Killgore Pharmacy
- Doing business as
- Killgore Pharmacy
- Doing business as
- Killlgore Pharmacy
Registry dates
- Enumerated
- 2023-02-27
- Last updated
- 2025-05-03
- Certified
- 2025-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.