Provider Demographics
NPI:1538384110
Name:JABS L.L.C.
Entity type:Organization
Organization Name:JABS L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:SURRENCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-394-4444
Mailing Address - Street 1:7902 HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-2443
Mailing Address - Country:US
Mailing Address - Phone:504-394-4444
Mailing Address - Fax:504-391-0405
Practice Address - Street 1:7902 HIGHWAY 23
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-2443
Practice Address - Country:US
Practice Address - Phone:504-394-4444
Practice Address - Fax:504-391-0405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2009-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1215236Medicaid