Provider Demographics
NPI:1902918857
Name:L & B ENTERPRISES
Entity Type:Organization
Organization Name:L & B ENTERPRISES
Other - Org Name:PLAZA PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RPH/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAYES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:606-723-5315
Mailing Address - Street 1:1220 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-7232
Mailing Address - Country:US
Mailing Address - Phone:606-723-5315
Mailing Address - Fax:606-723-8669
Practice Address - Street 1:1220 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-7232
Practice Address - Country:US
Practice Address - Phone:606-723-5315
Practice Address - Fax:606-723-8669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100621260Medicaid
2031465OtherPK