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General NPI Number Information
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NPI Number | 1326471541
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Entity Type | Organization
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Legal Business Name | JOHNRIZK ENTERPRISES LLC
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 12/08/2014
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Provider Practice Location Address
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Address Line | 27431 HIGHWAY 190
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City | LACOMBE
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State | LA
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Zip | 70445-6401
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Country | US
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Telephone | 985-882-6448
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Fax |
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Provider Business Mailing Address
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Address Line | 62001 OAK POINTE
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City | LACOMBE
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State | LA
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Zip | 70445-5820
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Country | US
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Telephone | 985-882-6448
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Fax |
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | JASON JOHNSON
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Credential |
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Telephone | 985-882-6448
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY.006736-IR
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License Number State | LA
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