Organization
MOUTON PHARMACY INC
Active
Other names
MOUTON PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW MOUTON (MANAGER/OWNER)
(337) 334-2117
Entity
Organization
Contact information
Practice address
301 S ADAMS AVE, RAYNE, LA 70578-5837
(337) 334-2117
(337) 334-7668
Mailing address
PO BOX 93, RAYNE, LA 70578-0093
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY.002569-IR
LA
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
OS01568
AR
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2032645
PK
—
05
—
2211382
—
LA
Enumeration date
10/03/2005
Last updated
08/27/2025
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