Provider Demographics
NPI:1669634267
Name:DELCAMBRE PHARMACY, INC
Entity Type:Organization
Organization Name:DELCAMBRE PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENNON
Authorized Official - Middle Name:EMILE
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:337-993-1464
Mailing Address - Street 1:510 HIGHWAY14 WEST
Mailing Address - Street 2:
Mailing Address - City:DELCAMBRE
Mailing Address - State:LA
Mailing Address - Zip Code:70528
Mailing Address - Country:US
Mailing Address - Phone:337-685-6851
Mailing Address - Fax:337-685-6853
Practice Address - Street 1:510 HWY14 WEST
Practice Address - Street 2:
Practice Address - City:DELCAMBRE
Practice Address - State:LA
Practice Address - Zip Code:70528
Practice Address - Country:US
Practice Address - Phone:337-685-6851
Practice Address - Fax:337-685-6853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA60043336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy