Healthcare Provider Details

I. General information

NPI: 1154725356
Provider Name (Legal Business Name): ESENBEE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2958 PERKINS RD
BATON ROUGE LA
70808-2248
US

IV. Provider business mailing address

2958 PERKINS RD
BATON ROUGE LA
70808-2248
US

V. Phone/Fax

Practice location:
  • Phone: 225-343-4869
  • Fax: 225-343-4819
Mailing address:
  • Phone: 225-343-4869
  • Fax: 225-343-4819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY006956-IR
License Number StateLA

VIII. Authorized Official

Name: STEVEN YELLOTT
Title or Position: OWNER
Credential:
Phone: 225-343-4869