MEDICARE: RICARD FAMILY PHARMACY, 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

General Provider Information

NPI Number	:	1790386936
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICARD FAMILY PHARMACY, LLC

Provider Business Mailing Address
First Line	:	42242 VETERANS AVE
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70403-1423
Country	:	US
Telephone Number	:	985-542-7230
Fax Number	:	985-542-7288

Provider Business Practice Location Address
First Line	:	42242 VETERANS AVE
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70403-1423
Country	:	US
Telephone Number	:	985-542-7230
Fax Number	:	985-542-7288

Authorized Official
Title or Position	:	OWNER/PHARMACIST
Name	:	JENNIFER RICARD
Credential	:	PHARMD
Telephone Number	:	985-542-7230

Provider Enumeration Date	:	11/04/2020
Last Update Date	:	11/04/2020

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