Provider Demographics
NPI:1992817845
Name:ST FRANCIS BUSINESS LLC
Entity type:Organization
Organization Name:ST FRANCIS BUSINESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-433-4692
Mailing Address - Street 1:820 MCKINLEY ST
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:LA
Mailing Address - Zip Code:70669-5300
Mailing Address - Country:US
Mailing Address - Phone:337-433-4692
Mailing Address - Fax:337-494-0303
Practice Address - Street 1:820 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:LA
Practice Address - Zip Code:70669-5300
Practice Address - Country:US
Practice Address - Phone:337-433-4692
Practice Address - Fax:337-494-0303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.006317-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2127317OtherPK
LA2200461Medicaid