Organization
TED S PHARMACY LLC
Active
Other names
Ted's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAN WARE (PIC)
(318) 624-1053
Entity
Organization
Contact information
Practice address
1866 MAIN ST, HAYNESVILLE, LA 71038-4904
(318) 624-1053
(318) 624-2233
Mailing address
1866 MAIN ST, HAYNESVILLE, LA 71038-4904
(318) 624-1053
(318) 624-2233
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.005750-IR
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1269719
—
LA
01
—
2029769
PK
—
Enumeration date
03/28/2007
Last updated
09/11/2023
Update your record
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