Healthcare Provider Details
I. General information
NPI: 1437229077
Provider Name (Legal Business Name): DUSON RX, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9021 CAMERON ST.
DUSON LA
70529
US
IV. Provider business mailing address
9021 CAMERON ST
DUSON LA
70529
US
V. Phone/Fax
- Phone: 337-873-6182
- Fax: 337-334-9899
- Phone: 337-873-6182
- Fax: 337-873-7629
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | 4959-IR |
| License Number State | LA |
VIII. Authorized Official
Name: MR.
RAPHAEL
J
MECHE
Title or Position: OWNER
Credential:
Phone: 337-873-6182