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General NPI Number Information
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NPI Number | 1962077008
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Entity Type | Organization
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Legal Business Name | JEFFERSON COMMUNITY HEALTH CARE CENTERS INC
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Dates
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Enumeration Date | 05/21/2021
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Last Update Date | 06/09/2025
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Provider Practice Location Address
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Address Line | 7001 LAPALCO BLVD
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City | MARRERO
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State | LA
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Zip | 70072
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Country | US
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Telephone | 504-766-7149
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Fax | 504-302-1421
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Provider Business Mailing Address
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Address Line | PO BOX 2490
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City | MARRERO
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State | LA
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Zip | 70073-2490
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHONDRA G WILLIAMS
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Credential |
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Telephone | 504-437-8531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 | 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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