Healthcare Provider Details

I. General information

NPI: 1407358484
Provider Name (Legal Business Name): THE BERNICE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 MAIN ST
BERNICE LA
71222-7122
US

IV. Provider business mailing address

PO BOX 636
BERNICE LA
71222-0636
US

V. Phone/Fax

Practice location:
  • Phone: 318-285-9521
  • Fax: 318-285-0185
Mailing address:
  • Phone: 318-285-9521
  • Fax: 318-285-0185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number007543
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. SARAH D JOHNSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 318-285-9521