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NPI Code Detail

MEDICARE: TOWNE PHARMACY LLC

MEDICARE: TOWNE PHARMACY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail PharmacyPHY.006633-IRLA

General Provider Information

NPI Number : 1598177917
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOWNE PHARMACY LLC
Provider Business Mailing Address
First Line : 103 E MAIN ST
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4616
Country : US
Telephone Number : 337-839-8880
Fax Number : 337-839-8881
Provider Business Practice Location Address
First Line : 103 E MAIN ST
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4616
Country : US
Telephone Number : 337-839-8880
Fax Number : 337-839-8881
Authorized Official
Title or Position : OWNER/PIC
Name : IVAN LANDRY
Credential :
Telephone Number : 337-839-8880
Provider Enumeration Date : 05/21/2014
Last Update Date : 05/21/2014

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