=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679732333
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | APC PHARMACEUTICALS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/06/2008
-----------------------------------------------------
Last Update Date | 06/06/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1103 KALISTE SALOOM RD SUITE 304
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70508-5783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-988-4824
-----------------------------------------------------
Fax | 337-704-0149
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1103 KALISTE SALOOM RD SUITE 304
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70508-5783
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-988-4824
-----------------------------------------------------
Fax | 337-704-0149
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PIC
-----------------------------------------------------
Name | KATHY RICHARD
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 337-344-0705
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY005998IR
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------