Provider Demographics
NPI:1679132393
Name:LAYTON PHARMACY L.L.C.
Entity type:Organization
Organization Name:LAYTON PHARMACY L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MITCHELL
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-888-1170
Mailing Address - Street 1:70457 HIGHWAY 21 STE 118
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70433-8155
Mailing Address - Country:US
Mailing Address - Phone:985-888-1170
Mailing Address - Fax:985-888-1167
Practice Address - Street 1:70457 HIGHWAY 21 STE 118
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8155
Practice Address - Country:US
Practice Address - Phone:985-888-1170
Practice Address - Fax:985-888-1167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy