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General NPI Number Information
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NPI Number | 1437294675
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Entity Type | Organization
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Legal Business Name | BRN INC.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 HOSPITAL DR SUITE 1
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City | OPELOUSAS
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State | LA
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Zip | 70570-6552
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Country | US
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Telephone | 337-948-6507
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Fax | 337-948-8624
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Provider Business Mailing Address
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Address Line | 1200 HOSPITAL DR SUITE 1
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City | OPELOUSAS
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State | LA
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Zip | 70570-6552
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Country | US
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Telephone | 337-948-6507
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Fax | 337-948-8624
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. SHANE A. TATMAN
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Credential | R.PH
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Telephone | 337-948-6507
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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 | 5469-IR
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License Number State | LA
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