Provider Demographics
NPI:1518568054
Name:CHRIS PHARMACY OF GONZALES LLC
Entity Type:Organization
Organization Name:CHRIS PHARMACY OF GONZALES LLC
Other - Org Name:CHRIS' PHARMACY IN GONZALES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:225-698-6000
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:LA
Mailing Address - Zip Code:70711-0328
Mailing Address - Country:US
Mailing Address - Phone:225-267-5700
Mailing Address - Fax:225-267-5707
Practice Address - Street 1:14505 HIGHWAY 44 STE 112
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-7195
Practice Address - Country:US
Practice Address - Phone:225-573-4578
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy