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Organization

JEFFERSON DRUG PHARMACY

Active
Other names
JEFFERSON DRUG PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SAMUEL AIGBFOH I PHARM.D, (OWNER)
(443) 540-4597
Entity
Organization

Contact information

Practice address
616 JEFFERSON BLVD, LAFAYETTE, LA 70501-7206
(337) 889-3795
(337) 889-3796
Mailing address
616 JEFFERSON BLVD, LAFAYETTE, LA 70501-7206
(337) 889-3795
(337) 889-3796

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2208241
LA
Enumeration date
12/14/2020
Last updated
05/07/2025
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