Organization
JEFFERY J SCALLAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA SCALLAN (EXEC)
(318) 992-3134
Entity
Organization
Contact information
Practice address
115 HWY 1181, PLAUCHEVILLE, LA 71362-1362
(318) 922-3134
(318) 922-3881
Mailing address
115 HWY 1181, PO BOX 98, PLAUCHEVILLE, LA 71362-0098
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
981IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1252239
—
LA
01
—
2029162
PK
—
Enumeration date
01/24/2007
Last updated
04/20/2018
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