# ICARE PHARMACY - JOHNSTON STREET LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** iCARE Pharmacy - Johnston St, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073625927
- **Authorized official:** CLEVELAND MICHAUD (OWNER)
- **Authorized official phone:** (337) 233-4782

## Contact information

- **Practice address:** 2039 JOHNSTON ST, LAFAYETTE, LA 70503-2784
- **Practice address phone:** (337) 233-4782
- **Practice address fax:** (337) 233-4783
- **Mailing address:** 2039 JOHNSTON ST, LAFAYETTE, LA 70503-2784
- **Mailing address phone:** (337) 233-4782
- **Mailing address fax:** (337) 233-4783

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY006927IR | LA | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 07/19/2018