Organization
CANNONS DISCOUNT PHARMACY LLC
Active
Other names
CANNONS DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES R. CANNON III PHARMD (MANAGING MEMBER)
(985) 878-5555
Entity
Organization
Contact information
Practice address
13351 E ALESSI RD, INDEPENDENCE, LA 70443-2398
(985) 878-5555
(985) 878-5553
Mailing address
13351 E ALESSI RD, INDEPENDENCE, LA 70443-2398
(985) 878-5555
(985) 878-5553
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.005972-IR
LA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1227901
—
LA
05
—
1268798
—
LA
01
—
2035430
PK
—
Enumeration date
01/30/2007
Last updated
09/29/2025
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