Provider Demographics
NPI:1578968384
Name:GUIDRY'S PHARMACY
Entity Type:Organization
Organization Name:GUIDRY'S PHARMACY
Other - Org Name:APOTHECARY ALLEY, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICKY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GUIDRY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:337-540-8504
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:204 SOUTH THOMSON AVE
Mailing Address - City:IOWA
Mailing Address - State:LA
Mailing Address - Zip Code:70647-0760
Mailing Address - Country:US
Mailing Address - Phone:337-582-3131
Mailing Address - Fax:337-582-3459
Practice Address - Street 1:204 SOUTH THOMSON AVE
Practice Address - Street 2:
Practice Address - City:IOWA
Practice Address - State:LA
Practice Address - Zip Code:70647
Practice Address - Country:US
Practice Address - Phone:337-582-3131
Practice Address - Fax:337-582-3459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPHY.006971-RC333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy