Provider Demographics
NPI:1538842190
Name:LOUISIANA DEPT OF SAFETY AND CORRECTIONS
Entity type:Organization
Organization Name:LOUISIANA DEPT OF SAFETY AND CORRECTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:E
Authorized Official - Last Name:LABATUT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:225-655-2307
Mailing Address - Street 1:17544 TUNICA TRCE
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:LA
Mailing Address - Zip Code:70712-3029
Mailing Address - Country:US
Mailing Address - Phone:225-655-2307
Mailing Address - Fax:225-655-2725
Practice Address - Street 1:17544 TUNICA TRCE
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:LA
Practice Address - Zip Code:70712-3029
Practice Address - Country:US
Practice Address - Phone:225-655-2307
Practice Address - Fax:225-655-2725
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DPS&C CORRECTIONS SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy