Provider Demographics
NPI:1356712566
Name:FRANCISE LLC
Entity type:Organization
Organization Name:FRANCISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC/AO
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-774-2795
Mailing Address - Street 1:18559 ANDREW JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3218
Mailing Address - Country:US
Mailing Address - Phone:225-774-2795
Mailing Address - Fax:225-774-2794
Practice Address - Street 1:14620 PLANK RD
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-5434
Practice Address - Country:US
Practice Address - Phone:225-774-2795
Practice Address - Fax:225-774-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.007193-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154341OtherPK
LA2204068Medicaid