Jefferson Pharmacy,LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

JEFFERSON PHARMACY,LLC

Practice address

620 Jefferson Blvd
Lafayette, LA 70501-7206

Phone

(337) 234-1428

Fax

(337) 234-1429

NPI assigned

Nov 27, 2006

Last updated

Sep 10, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard T Djapni, PHD

Title

Owner

Phone

(337) 255-4238

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Baque Enterprise LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Baque Enterprise LLC

  dba Jefferson Drug Store

  • Community/Retail Pharmacy
  • Lafayette, LA
  • NPI 1831505536
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard Ewell Hebert, RPH

  • Pharmacist
  • Lafayette, LA
  • NPI 1891905071
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1922174689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JEFFERSON BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70501",
            "telephone_number": "337-234-1428",
            "fax_number": "337-234-1429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JEFFERSON BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705017206",
            "telephone_number": "337-234-1428",
            "fax_number": "337-234-1429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFERSON PHARMACY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "DJAPNI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-255-4238",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2207113",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Edie Marie Jeanlouis Harrison
• Patience Jeanlouis
• Christopher Todd Jeansonne, FNP
• Crystal White Jeansonne, FNP
• Jefferson Drug Pharmacy
• Jefferson Street Clinic LLC (Jefferson Street Clinic)
• Jefferson Street Primary Care Clinic
• Emmett Jefferson III
• Kelsey R Jefferson
• Morgan Jeknavorian, RRT

• Pharmacy in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.