Healthcare Provider Details

I. General information

NPI: 1750495735
Provider Name (Legal Business Name): DH BYNUM ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 10/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 ORANGE ST
MONROE LA
71202-2319
US

IV. Provider business mailing address

1215 ORANGE ST
MONROE LA
71202-2319
US

V. Phone/Fax

Practice location:
  • Phone: 318-388-2669
  • Fax: 318-387-5377
Mailing address:
  • Phone: 318-388-2669
  • Fax: 318-387-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.004297-IR
License Number StateLA

VIII. Authorized Official

Name: DRURY BYNUM
Title or Position: OWNER / CEO
Credential: RPH MBA FASCP
Phone: 318-388-2669