Individual
JOHN BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
833 W MAIN ST, HOMER, LA 71040-3322
(318) 927-3523
(318) 927-3526
Mailing address
126 CARONDELET CT, BOSSIER CITY, LA 71111-5478
(318) 550-5212
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15778
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15778
STATE LICENSE
LA
Enumeration date
10/01/2010
Last updated
04/11/2022
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