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General NPI Number Information
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NPI Number | 1508936501
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Entity Type | Organization
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Legal Business Name | THE DRUG STORE, LLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 857 SAM HOUSTON JONES PKWY
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City | LAKE CHARLES
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State | LA
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Zip | 70611-5504
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Country | US
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Telephone | 337-855-1990
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Fax | 337-855-1901
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Provider Business Mailing Address
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Address Line | 857 SAM HOUSTON JONES PKWY
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City | LAKE CHARLES
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State | LA
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Zip | 70611-5504
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Country | US
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Telephone | 337-855-1990
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Fax | 337-855-1901
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Authorized Official
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Title or Position | PHARMACIST OWNER
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Name | MRS. SHANA MURPHY PREJEAN
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Credential | R.PH.
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Telephone | 337-855-1990
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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 | 005324-IR
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License Number State | LA
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