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Organization
HEALTH MART OF LAFAYETTE LLC
Active
Organization
HEALTH MART OF LAFAYETTE LLC
Active
Other names
Health Mart Pharmacy of Lafayette
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY DAVID RPH (OWNER PRESIDENT)
(337) 235-3523
Entity
Organization
Contact information
Practice address
600 JOHNSTON ST, LAFAYETTE, LA 70501-8060
(337) 235-3523
(337) 233-1518
Mailing address
818 N CUSHING AVE, KAPLAN, LA 70548-2615
(337) 235-3523
(337) 233-1518
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY006433IR
LA
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132567
PK
—
05
—
2201000
—
LA
Enumeration date
11/01/2006
Last updated
09/16/2016
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