Organization
PAINCOURTVILLE PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SAGONA JR. (OWNER)
(985) 369-3578
Entity
Organization
Contact information
Practice address
112 HWY 403, PAINCOURTVILLE, LA 70391
(985) 369-3578
(985) 369-3579
Mailing address
PO BOX 420, PAINCOURTVILLE, LA 70391-0420
(985) 369-3578
(395) 369-3579
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17136
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234125
—
LA
01
—
1915202
NCPDP
LA
Enumeration date
09/19/2006
Last updated
07/21/2022
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