Organization
MEDCOMP RX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA P MARIONNEAUX PHARM.D. (HEAD PHARMACIST)
(225) 286-4427
Entity
Organization
Contact information
Practice address
5500 FIRE STATION RD, SUITE A, ZACHARY, LA 70791-7468
(225) 286-4427
(225) 570-8238
Mailing address
PO BOX 800, SUITE A, ZACHARY, LA 70791
(225) 286-4427
(225) 570-8238
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2204335
—
LA
Enumeration date
03/06/2015
Last updated
04/14/2016
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