Provider Demographics
NPI:1558969865
Name:FOIL, ROSCOE FLOYD JR
Entity Type:Individual
Prefix:
First Name:ROSCOE
Middle Name:FLOYD
Last Name:FOIL
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:BOGALUSA
Mailing Address - State:LA
Mailing Address - Zip Code:70427-3101
Mailing Address - Country:US
Mailing Address - Phone:985-732-5874
Mailing Address - Fax:
Practice Address - Street 1:133 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:BOGALUSA
Practice Address - State:LA
Practice Address - Zip Code:70427-3101
Practice Address - Country:US
Practice Address - Phone:985-732-5874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.011317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist