Provider Demographics
NPI:1497588156
Name:ALLEN AND BAUM PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:ALLEN AND BAUM PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:318-502-0062
Mailing Address - Street 1:104 W LINE AVE
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-5044
Mailing Address - Country:US
Mailing Address - Phone:318-255-7363
Mailing Address - Fax:
Practice Address - Street 1:208 BOOTS DR
Practice Address - Street 2:
Practice Address - City:FARMERVILLE
Practice Address - State:LA
Practice Address - Zip Code:71241-3102
Practice Address - Country:US
Practice Address - Phone:318-368-9711
Practice Address - Fax:318-368-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy