Provider Demographics
NPI:1437668597
Name:JBL RX LLC
Entity Type:Organization
Organization Name:JBL RX LLC
Other - Org Name:COMEAUX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARTINA
Authorized Official - Last Name:COMEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-339-3356
Mailing Address - Street 1:2305 WEST ESPLANADE AVE. SUITE T
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-3728
Mailing Address - Country:US
Mailing Address - Phone:504-305-1745
Mailing Address - Fax:504-305-5555
Practice Address - Street 1:2305 WEST ESPLANADE AVE
Practice Address - Street 2:SUITE T
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065
Practice Address - Country:US
Practice Address - Phone:504-305-1745
Practice Address - Fax:504-305-5555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA333600000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy