Provider Demographics
NPI:1295802627
Name:DANIEL PHARMACY LLC
Entity type:Organization
Organization Name:DANIEL PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-749-2020
Mailing Address - Street 1:409 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRUSLY
Mailing Address - State:LA
Mailing Address - Zip Code:70719-2208
Mailing Address - Country:US
Mailing Address - Phone:225-749-2020
Mailing Address - Fax:225-749-8050
Practice Address - Street 1:409 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRUSLY
Practice Address - State:LA
Practice Address - Zip Code:70719-2208
Practice Address - Country:US
Practice Address - Phone:225-749-2020
Practice Address - Fax:225-749-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1258997Medicaid