Organization
LOUISIANA SPECIALTY PHARMACY INC
Active
Other names
Louisiana Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY DAVID (CEO/OWNER)
(337) 235-7622
Entity
Organization
Contact information
Practice address
600 JOHNSTON ST STE B, LAFAYETTE, LA 70501-8060
(337) 235-7622
(337) 484-3504
Mailing address
818 N CUSHING AVE, KAPLAN, LA 70548-2615
(337) 643-7952
(337) 643-7953
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
PHY007142IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151618
PK
—
05
—
2203843
—
LA
Enumeration date
07/16/2015
Last updated
12/22/2015
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