# JEFFERSON DRUG PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JEFFERSON DRUG PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104412154
- **Authorized official:** DR. SAMUEL AIGBFOH I PHARM.D, (OWNER)
- **Authorized official phone:** (443) 540-4597

## Contact information

- **Practice address:** 616 JEFFERSON BLVD, LAFAYETTE, LA 70501-7206
- **Practice address phone:** (337) 889-3795
- **Practice address fax:** (337) 889-3796
- **Mailing address:** 616 JEFFERSON BLVD, LAFAYETTE, LA 70501-7206
- **Mailing address phone:** (337) 889-3795
- **Mailing address fax:** (337) 889-3796

## Taxonomy

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

## Other

- **Enumeration date:** 12/14/2020
- **Last updated:** 05/07/2025