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General NPI Number Information
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NPI Number | 1730277369
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Entity Type | Organization
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Legal Business Name | EVANGELINE DRUG STORE INC
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 10 W MAIN ST
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City | VILLE PLATTE
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State | LA
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Zip | 70586-4566
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Country | US
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Telephone | 337-363-3456
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Fax | 337-363-3333
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Provider Business Mailing Address
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Address Line | PO BOX 370
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City | VILLE PLATTE
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State | LA
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Zip | 70586-0370
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Country | US
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Telephone | 337-363-3456
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Fax | 337-363-3333
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | MR. HARVEY BERNARD LEBAS
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Credential | P.D.
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Telephone | 337-363-3456
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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 | 342-IR
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License Number State | LA
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