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Organization
IBERIA COMPREHENSIVE CHC PHARMACY
Active
Organization
IBERIA COMPREHENSIVE CHC PHARMACY
Active
Other names
IBERIA COMPREHENSIVE CHC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
REGINALD BOUTTE RPH (PIC)
(337) 376-6868
Entity
Organization
Contact information
Practice address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 376-6868
(337) 376-6866
Mailing address
806 JEFFERSON TER, NEW IBERIA, LA 70560-5727
(337) 376-6868
(337) 376-6866
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5987
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2035620
PK
—
Enumeration date
01/28/2008
Last updated
12/01/2021
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