Organization
JOHNRIZK ENTERPRISES LLC
Active
Other names
Bayou Lacombe Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASON JOHNSON (OWNER/PHARMACIST)
(985) 882-6448
Entity
Organization
Contact information
Practice address
27431 HIGHWAY 190, LACOMBE, LA 70445-6401
(985) 882-6448
Mailing address
62001 OAK POINTE, LACOMBE, LA 70445-5820
(985) 882-6448
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006736-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140612
PK
—
05
—
2202189
—
LA
Enumeration date
08/12/2013
Last updated
12/08/2014
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