Healthcare Provider Details

I. General information

NPI: 1194122440
Provider Name (Legal Business Name): MULA FAMILY PHARMACY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2619 CHARITY ST
ABBEVILLE LA
70510-4024
US

IV. Provider business mailing address

2619 CHARITY ST
ABBEVILLE LA
70510-4024
US

V. Phone/Fax

Practice location:
  • Phone: 337-385-1250
  • Fax: 337-385-1247
Mailing address:
  • Phone: 337-385-1250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK E MULA
Title or Position: PHARMACIST IN CHARGE/OWNER
Credential: RPH
Phone: 337-385-1250