Organization
LFR ENTERPRISES
Active
Other names
Floyd's Family Pharmacy #2 (Bedico)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE DOUGLAS TALLEY CPHT (MANAGER)
(985) 206-9911
Entity
Organization
Contact information
Practice address
28471 HIGHWAY 22, PONCHATOULA, LA 70454-6143
(985) 206-9911
(985) 206-9914
Mailing address
28471 HIGHWAY 22, PONCHATOULA, LA 70454-6143
(985) 206-9911
(985) 206-9914
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2207181
—
LA
01
—
CDS.055691-PHY
CDS
LA
Enumeration date
03/19/2019
Last updated
10/27/2022
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