Provider Demographics
NPI:1558760041
Name:WEBB, LORI BOYETT (RPH)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:BOYETT
Last Name:WEBB
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3670 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-4474
Mailing Address - Country:US
Mailing Address - Phone:318-992-1357
Mailing Address - Fax:318-992-1360
Practice Address - Street 1:3670 W OAK ST
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-4474
Practice Address - Country:US
Practice Address - Phone:318-992-1357
Practice Address - Fax:318-992-1360
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist