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General NPI Number Information
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NPI Number | 1396859377
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Entity Type | Organization
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Legal Business Name | IDEAL PHARMACY OF FRANKLINTON LLC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 808 RIVERSIDE DR
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City | FRANKLINTON
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State | LA
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Zip | 70438-3634
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Country | US
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Telephone | 985-839-4668
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Fax | 985-839-4669
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Provider Business Mailing Address
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Address Line | 808 RIVERSIDE DR
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City | FRANKLINTON
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State | LA
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Zip | 70438-3634
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Country | US
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Telephone | 985-839-4668
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Fax | 985-839-4669
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Authorized Official
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Title or Position | MEMBER
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Name | C BURKHALTER
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Credential |
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Telephone | 985-839-4668
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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 | 3336L0003X
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Taxonomy Name | Long Term Care 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 | 1936IR
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License Number State | LA
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