Provider Demographics
NPI:1790858934
Name:LAPERLE'S IGA PHARMACY, INC
Entity Type:Organization
Organization Name:LAPERLE'S IGA PHARMACY, INC
Other - Org Name:LAPERLES'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SUPERVISING PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUG
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:603-237-5033
Mailing Address - Street 1:64 TROOPER LESLIE LORD MEMORIAL HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:COLEBROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03576
Mailing Address - Country:US
Mailing Address - Phone:603-237-5033
Mailing Address - Fax:603-237-5133
Practice Address - Street 1:64 TROOPER LESLIE G LORD MEM HWY
Practice Address - Street 2:
Practice Address - City:COLEBROOK
Practice Address - State:NH
Practice Address - Zip Code:03576-3006
Practice Address - Country:US
Practice Address - Phone:603-237-5033
Practice Address - Fax:603-237-5133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0690-P3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy