Provider Demographics
NPI:1639265366
Name:HESSMER PHARMACY, INC
Entity Type:Organization
Organization Name:HESSMER PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:I
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:318-563-4523
Mailing Address - Street 1:P O BOX 7
Mailing Address - Street 2:
Mailing Address - City:HESSMER
Mailing Address - State:LA
Mailing Address - Zip Code:71341
Mailing Address - Country:US
Mailing Address - Phone:318-563-4523
Mailing Address - Fax:318-563-4850
Practice Address - Street 1:3658 HIGHWAY 115
Practice Address - Street 2:
Practice Address - City:HESSMER
Practice Address - State:LA
Practice Address - Zip Code:71341
Practice Address - Country:US
Practice Address - Phone:318-563-4523
Practice Address - Fax:318-563-4850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12733336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1220183Medicaid
LA1220183Medicaid