Healthcare Provider Details

I. General information

NPI: 1265541171
Provider Name (Legal Business Name): NEW PARRINO DRUG STORE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 SW MAIN ST
BUNKIE LA
71322-1781
US

IV. Provider business mailing address

208 SW MAIN ST P.O. BOX 177
BUNKIE LA
71322-1781
US

V. Phone/Fax

Practice location:
  • Phone: 318-346-7204
  • Fax: 318-346-7282
Mailing address:
  • Phone: 318-346-7204
  • Fax: 318-346-7282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10226
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RICHARD THIBAUT FEUZING DJAPNI
Title or Position: OWNER
Credential:
Phone: 318-793-2400