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General NPI Number Information
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NPI Number | 1174514517
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Entity Type | Organization
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Legal Business Name | HEAROD DRUGS INC.
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1615 JOHNSON ST SUITE D
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City | JENNINGS
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State | LA
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Zip | 70546-3650
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Country | US
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Telephone | 337-824-2238
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1255
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City | JENNINGS
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State | LA
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Zip | 70546-1255
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/STORE MANAGER
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Name | MRS. GEORGIA PREJEAN
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Credential | R.PH
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Telephone | 337-824-2238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5029-IR
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License Number State | LA
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