# TED S PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ted's Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538288113
- **Authorized official:** DAN WARE (PIC)
- **Authorized official phone:** (318) 624-1053

## Contact information

- **Practice address:** 1866 MAIN ST, HAYNESVILLE, LA 71038-4904
- **Practice address phone:** (318) 624-1053
- **Practice address fax:** (318) 624-2233
- **Mailing address:** 1866 MAIN ST, HAYNESVILLE, LA 71038-4904
- **Mailing address phone:** (318) 624-1053
- **Mailing address fax:** (318) 624-2233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY.005750-IR | LA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 09/11/2023