Healthcare Provider Details

I. General information

NPI: 1700989878
Provider Name (Legal Business Name): TURNER REXALL PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 E MAIN ST PO DRAWER 1003
OAK GROVE LA
71263-1003
US

IV. Provider business mailing address

411 E MAIN ST PO DRAWER 1003
OAK GROVE LA
71263-1003
US

V. Phone/Fax

Practice location:
  • Phone: 318-428-4205
  • Fax: 318-428-4207
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberC001141IR
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DENA FERMAN
Title or Position: THIRD PARTY PLAN COORDINATOR
Credential:
Phone: 314-993-6000