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General NPI Number Information
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NPI Number | 1174573182
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Entity Type | Organization
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Legal Business Name | CENTRAL PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 811 MARTIN LUTHER KING JR DR
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City | LAFAYETTE
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State | LA
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Zip | 70501-1845
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Country | US
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Telephone | 337-236-6609
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Fax | 337-236-6621
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Provider Business Mailing Address
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Address Line | 811 MARTIN LUTHER KING JR DR
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City | LAFAYETTE
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State | LA
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Zip | 70501-1845
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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 | MGING OFFICER OF PHCY
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Name | JASON REED
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Credential | RPH
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Telephone | 337-802-1336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5651 IR
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License Number State | LA
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