Healthcare Provider Details

I. General information

NPI: 1457941650
Provider Name (Legal Business Name): ALBANY FAMILY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2021
Last Update Date: 05/26/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19067 FLORIDA BLVD
ALBANY LA
70711-3603
US

IV. Provider business mailing address

1812 W THOMAS ST
HAMMOND LA
70401-2945
US

V. Phone/Fax

Practice location:
  • Phone: 225-567-7772
  • Fax: 225-567-7773
Mailing address:
  • Phone: 985-345-4767
  • Fax: 985-345-4768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DANA ANTOON
Title or Position: MANAGER
Credential:
Phone: 985-345-4767