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Organization
PF SPAM LLC
Active
Organization
PF SPAM LLC
Active
Other names
PAULS PHARMACY, Paul's Pharmacy Independence
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER MICHELLE GAGNEAUX (SUPERVISOR)
(985) 878-4401
Entity
Organization
Contact information
Practice address
345 W RAILROAD AVE, INDEPENDENCE, LA 70443-2292
(985) 878-4401
(985) 878-3657
Mailing address
PO BOX 850, INDEPENDENCE, LA 70443-0850
(985) 878-4401
(985) 878-3657
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY.000204-IR
LA
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Enumeration date
10/23/2006
Last updated
04/19/2022
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