Provider Demographics
NPI:1568523744
Name:DON CHAUCER'S PHARMACY, INC
Entity Type:Organization
Organization Name:DON CHAUCER'S PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHAUCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-345-7979
Mailing Address - Street 1:15794 MEDICAL ARTS PLAZA
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-1446
Mailing Address - Country:US
Mailing Address - Phone:985-345-7979
Mailing Address - Fax:985-345-7493
Practice Address - Street 1:15794 MEDICAL ARTS PLAZA
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1446
Practice Address - Country:US
Practice Address - Phone:985-345-7979
Practice Address - Fax:985-345-7493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA24013336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1259543Medicaid
LA1065030001Medicare ID - Type Unspecified