Healthcare Provider Details

I. General information

NPI: 1538260658
Provider Name (Legal Business Name): BEGNEAUD'S PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1164 COOLIDGE BLVD
LAFAYETTE LA
70503-2619
US

IV. Provider business mailing address

1164 COOLIDGE BLVD
LAFAYETTE LA
70503-2619
US

V. Phone/Fax

Practice location:
  • Phone: 337-234-9488
  • Fax: 337-234-9480
Mailing address:
  • Phone: 337-234-9488
  • Fax: 337-234-9480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15749
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number1190
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number61-IR
License Number StateLA

VIII. Authorized Official

Name: MRS. LOUISE B GANUCHEAU
Title or Position: OWNER
Credential:
Phone: 337-234-9488