Organization
ICARE PHARMACY - JOHNSTON STREET LLC
Active
Other names
iCARE Pharmacy - Johnston St, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CLEVELAND MICHAUD (OWNER)
(337) 233-4782
Entity
Organization
Contact information
Practice address
2039 JOHNSTON ST, LAFAYETTE, LA 70503-2784
(337) 233-4782
(337) 233-4783
Mailing address
2039 JOHNSTON ST, LAFAYETTE, LA 70503-2784
(337) 233-4782
(337) 233-4783
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY006927IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147225
PK
—
05
—
2202972
—
LA
Enumeration date
08/31/2006
Last updated
07/19/2018
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