Organization
ROCK BEN INC
Active
Other names
GLENNS FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT LE BAS PD (PIC OWNER)
(337) 948-9827
Entity
Organization
Contact information
Practice address
1615 N MAIN ST, OPELOUSAS, LA 70570-6618
(337) 948-9827
(337) 948-6553
Mailing address
1615 N MAIN ST, OPELOUSAS, LA 70570-6618
(337) 948-9827
(337) 948-6553
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY004110IR
LA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1266396
—
LA
01
—
2030833
PK
—
Enumeration date
08/14/2006
Last updated
07/19/2018
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