Healthcare Provider Details

I. General information

NPI: 1659560811
Provider Name (Legal Business Name): DAIGLE PHARMACIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 BUSINESS 190
COVINGTON LA
70433-3285
US

IV. Provider business mailing address

1000 BUSINESS 190
COVINGTON LA
70433-3285
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-3211
  • Fax: 985-892-3744
Mailing address:
  • Phone: 985-892-3211
  • Fax: 985-892-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DENA FERMAN
Title or Position: THIRD PARTY PLAN COORDINATOR
Credential:
Phone: 314-993-6000