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General NPI Number Information
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NPI Number | 1750446183
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Entity Type | Organization
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Legal Business Name | LAKE CHARLES PHARMACEUTICAL SUPPLY COMPANY LLC
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 04/28/2021
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Provider Practice Location Address
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Address Line | 1717 OAK PARK BLVD STE 110
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8977
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Country | US
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Telephone | 337-494-2990
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Fax | 337-494-2550
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Provider Business Mailing Address
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Address Line | 1717 OAK PARK BLVD STE 110
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City | LAKE CHARLES
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State | LA
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Zip | 70601-8977
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Country | US
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Telephone | 337-494-2990
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Fax | 337-494-2550
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | AMANDA JOINER SALTZMAN
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Credential |
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Telephone | 337-494-2990
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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 |
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License Number State |
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