Healthcare Provider Details

I. General information

NPI: 1689910960
Provider Name (Legal Business Name): LACOMBE FAMILY PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2012
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28079 US HWY 190
LACOMBE LA
70445
US

IV. Provider business mailing address

PO BOX 1063
LACOMBE LA
70445
US

V. Phone/Fax

Practice location:
  • Phone: 985-882-5999
  • Fax: 985-882-5111
Mailing address:
  • Phone: 985-882-5999
  • Fax: 985-882-5111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number006646
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.006646.IR
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY BYRON BONDI
Title or Position: OWNER/PIC
Credential: PHARMD
Phone: 985-882-5999