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General NPI Number Information
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NPI Number | 1194890731
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Entity Type | Organization
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Legal Business Name | COMPOUNDING PHARMACIES OF LOUISIANA, INC.
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/27/2020
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Provider Practice Location Address
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Address Line | 128 CURRAN LN
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City | LAFAYETTE
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State | LA
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Zip | 70506-7222
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Country | US
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Telephone | 337-991-0101
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Fax | 337-991-0151
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Provider Business Mailing Address
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Address Line | 128 CURRAN LN
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City | LAFAYETTE
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State | LA
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Zip | 70506-7222
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Country | US
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Telephone | 337-991-0101
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Fax | 337-991-0151
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Authorized Official
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Title or Position | PHARMACIST CO-OWNER
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Name | DAVID P MAYER
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Credential | RPH
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Telephone | 337-991-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 3931
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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