Provider Demographics
NPI:1639702087
Name:TECHE ACTION BOARD, INC.
Entity Type:Organization
Organization Name:TECHE ACTION BOARD, INC.
Other - Org Name:TECHE ACTION CLINIC PHARMACY MORGAN CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-828-2550
Mailing Address - Street 1:1124 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-1951
Mailing Address - Country:US
Mailing Address - Phone:985-385-9925
Mailing Address - Fax:985-385-9931
Practice Address - Street 1:1124 7TH ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1951
Practice Address - Country:US
Practice Address - Phone:985-385-9925
Practice Address - Fax:853-859-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-13
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy