Provider Demographics
NPI:1427761204
Name:IOTA FAMILY PHARMACY INC.
Entity type:Organization
Organization Name:IOTA FAMILY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:337-523-4433
Mailing Address - Street 1:PO BOX 570
Mailing Address - Street 2:
Mailing Address - City:IOTA
Mailing Address - State:LA
Mailing Address - Zip Code:70543-0570
Mailing Address - Country:US
Mailing Address - Phone:337-779-2214
Mailing Address - Fax:337-779-2215
Practice Address - Street 1:119 S 5TH ST STE B
Practice Address - Street 2:
Practice Address - City:IOTA
Practice Address - State:LA
Practice Address - Zip Code:70543-6106
Practice Address - Country:US
Practice Address - Phone:337-779-2214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy