Provider Demographics
NPI:1922493337
Name:NEIGHBORS PHARMACY
Entity Type:Organization
Organization Name:NEIGHBORS PHARMACY
Other - Org Name:NEIGHBORS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BODIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-962-6877
Mailing Address - Street 1:6770 JOHNSTON ST STE A
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-6202
Mailing Address - Country:US
Mailing Address - Phone:337-706-7706
Mailing Address - Fax:337-706-7729
Practice Address - Street 1:6770 JOHNSTON ST
Practice Address - Street 2:SUITE-A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-6202
Practice Address - Country:US
Practice Address - Phone:337-706-7706
Practice Address - Fax:337-706-7729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-02
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPHY.007094-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2151129OtherPK