Healthcare Provider Details

I. General information

NPI: 1972605384
Provider Name (Legal Business Name): SWLA CENTER FOR HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OPELOUSAS ST
LAKE CHARLES LA
70601-2641
US

IV. Provider business mailing address

2000 OPELOUSAS ST
LAKE CHARLES LA
70601-2641
US

V. Phone/Fax

Practice location:
  • Phone: 337-493-5144
  • Fax: 337-944-9020
Mailing address:
  • Phone: 337-493-5144
  • Fax: 337-944-9020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.005697-IR
License Number StateLA

VIII. Authorized Official

Name: FRANCESCA JOUBERT
Title or Position: PHARMACY DIRECTOR
Credential: RPH
Phone: 337-493-5144