Provider Demographics
NPI:1730416009
Name:JAMES DRUG STORE
Entity type:Organization
Organization Name:JAMES DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHARMACY TECHNICIAN
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LATRAZ
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:225-270-2494
Mailing Address - Street 1:9889 HOOPER RD
Mailing Address - Street 2:APT A4
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-4641
Mailing Address - Country:US
Mailing Address - Phone:225-270-2494
Mailing Address - Fax:
Practice Address - Street 1:257 FLORIDA BLVD
Practice Address - Street 2:SE
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-3728
Practice Address - Country:US
Practice Address - Phone:225-665-5186
Practice Address - Fax:225-665-8633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-07
Last Update Date:2009-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA006379183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183700000XPharmacy Service ProvidersPharmacy TechnicianGroup - Multi-Specialty