Organization Name: | EVANGELINE DRUG STORE INC |
NPI Number: | 1730277369 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HARVEY BERNARD LEBAS (OWNER/PHARMACIST) |
Mailing Address: | 10 W Main St Ville Platte |
State: | LA US |
Postal Code: | 705864566 |
Phone Number: | 3373633456 |
Fax Number: | 3373633333 |
NPI Enumeration Date: | 10/10/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |