Provider Demographics
NPI:1801842471
Name:BEENE FAMILY PHARMACY LLC
Entity Type:Organization
Organization Name:BEENE FAMILY PHARMACY LLC
Other - Org Name:BEENE'S DRUG STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:681-238-2860
Mailing Address - Street 1:402 E DARROW ST
Mailing Address - Street 2:
Mailing Address - City:TALLULAH
Mailing Address - State:LA
Mailing Address - Zip Code:71282-3512
Mailing Address - Country:US
Mailing Address - Phone:318-574-1351
Mailing Address - Fax:318-574-0539
Practice Address - Street 1:402 E DARROW ST
Practice Address - Street 2:
Practice Address - City:TALLULAH
Practice Address - State:LA
Practice Address - Zip Code:71282-3512
Practice Address - Country:US
Practice Address - Phone:318-574-1351
Practice Address - Fax:318-574-0539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BX2000X
LA4366IR3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1267635Medicaid
LA1929326OtherNCPDP
LA1929326OtherNCPDP