Provider Demographics
NPI:1497190227
Name:MEDICAL PHARMACY INC.
Entity Type:Organization
Organization Name:MEDICAL PHARMACY INC.
Other - Org Name:HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LETARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-654-6884
Mailing Address - Street 1:PO BOX 475
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-0475
Mailing Address - Country:US
Mailing Address - Phone:225-654-6884
Mailing Address - Fax:
Practice Address - Street 1:4965 W. PARK DRIVE
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791
Practice Address - Country:US
Practice Address - Phone:225-654-6884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDICAL HEALTHMART PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-05-07
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
LA2235IR3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy