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General NPI Number Information
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NPI Number | 1326431982
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Entity Type | Organization
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Legal Business Name | MEDCOMP RX
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Dates
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Enumeration Date | 03/06/2015
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Last Update Date | 04/14/2016
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Provider Practice Location Address
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Address Line | 5500 FIRE STATION RD SUITE A
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City | ZACHARY
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State | LA
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Zip | 70791-7468
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Country | US
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Telephone | 225-286-4427
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Fax | 225-570-8238
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Provider Business Mailing Address
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Address Line | PO BOX 800 SUITE A
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City | ZACHARY
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State | LA
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Zip | 70791
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Country | US
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Telephone | 225-286-4427
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Fax | 225-570-8238
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Authorized Official
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Title or Position | HEAD PHARMACIST
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Name | ALICIA P MARIONNEAUX
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Credential | PHARM.D.
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Telephone | 225-286-4427
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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 |
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License Number State |
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