Provider Demographics
NPI:1134456619
Name:MY PHARMACY OF MONROE, LLC.
Entity Type:Organization
Organization Name:MY PHARMACY OF MONROE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:T
Authorized Official - Last Name:DJAPNI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-255-4238
Mailing Address - Street 1:1734 S 9TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-3526
Mailing Address - Country:US
Mailing Address - Phone:318-387-6725
Mailing Address - Fax:318-387-6723
Practice Address - Street 1:1734 S 9TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-3526
Practice Address - Country:US
Practice Address - Phone:318-387-6725
Practice Address - Fax:318-387-6723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6197-IR3336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy