Organization
PONCHATOULA FAMILY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA ANTOON (OWNER/MANAGER)
(985) 345-4767
Entity
Organization
Contact information
Practice address
19008 HIGHWAY 22, PONCHATOULA, LA 70454-6780
(985) 386-6556
(985) 386-6552
Mailing address
1812 W THOMAS ST, HAMMOND, LA 70401-2945
(985) 345-4767
(985) 345-4768
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2208748
—
LA
Enumeration date
07/07/2021
Last updated
02/21/2025
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