Healthcare Provider Details

I. General information

NPI: 1083975486
Provider Name (Legal Business Name): ZACHARY RX INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 CHURCH POINT HWY STE A
RAYNE LA
70578-7661
US

IV. Provider business mailing address

PO BOX 578
RAYNE LA
70578-0578
US

V. Phone/Fax

Practice location:
  • Phone: 225-658-0608
  • Fax: 800-729-0167
Mailing address:
  • Phone: 337-334-9979
  • Fax: 337-334-9899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number6516
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAPHAEL MECHE
Title or Position: OWNER
Credential:
Phone: 337-334-3399