MEDICARE: MEDICAL PHARMACY INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336L0003X	Long Term Care Pharmacy
3	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477616274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL PHARMACY INC.

Provider Business Mailing Address
First Line	:	PO BOX 475
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-0475
Country	:	US
Telephone Number	:	225-654-8383
Fax Number	:	225-654-9366

Provider Business Practice Location Address
First Line	:	6400 MAIN ST
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-4039
Country	:	US
Telephone Number	:	225-654-8383
Fax Number	:	225-654-9366

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	MRS. AUDREY LETARD
Credential	:
Telephone Number	:	225-654-8383

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	07/09/2020

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