Healthcare Provider Details
I. General information
NPI: 1689767840
Provider Name (Legal Business Name): HONEYCUTT, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2835 E OAK ST
JENA LA
71342-1350
US
IV. Provider business mailing address
PO BOX 1350
JENA LA
71342
US
V. Phone/Fax
- Phone: 318-992-4574
- Fax: 318-992-5635
- Phone: 318-992-4574
- Fax: 318-992-5635
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 333600000X |
| Taxonomy | Pharmacy |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336L0003X |
| Taxonomy | Long Term Care Pharmacy |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | 2213IR |
| License Number State | LA |
VIII. Authorized Official
Name: MRS.
LAGENA
L
DUBOIS
Title or Position: OFFICE MANAGER/ CPHT
Credential: CPHT
Phone: 318-793-2400