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General NPI Number Information
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NPI Number | 1740560192
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Entity Type | Organization
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Legal Business Name | NORTH LOUISIANA PHARMACEUTICAL COMPANY INC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 833 W MAIN ST
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City | HOMER
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State | LA
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Zip | 71040-3322
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Country | US
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Telephone | 318-927-3523
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Fax | 318-927-3526
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Provider Business Mailing Address
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Address Line | PO BOX 729
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City | BENTON
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State | LA
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Zip | 71006-0729
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Country | US
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Telephone | 318-927-3523
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Fax | 318-927-3526
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Authorized Official
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Title or Position | OWNER
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Name | JOHN BANNISTER
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Credential |
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Telephone | 318-927-3523
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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 | 3336C0004X
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Taxonomy Name | Compounding 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 | PHY.007234-IR
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License Number State | LA
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