MEDICARE: MY PHARMACY OF MONROE, LLC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	6197-IR	LA
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1134456619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MY PHARMACY OF MONROE, LLC.

Provider Business Mailing Address
First Line	:	1734 S 9TH ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-3526
Country	:	US
Telephone Number	:	318-387-6725
Fax Number	:	318-387-6723

Provider Business Practice Location Address
First Line	:	1734 S 9TH ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-3526
Country	:	US
Telephone Number	:	318-387-6725
Fax Number	:	318-387-6723

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD T DJAPNI
Credential	:
Telephone Number	:	337-255-4238

Provider Enumeration Date	:	11/04/2009
Last Update Date	:	01/27/2021

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