| NPI | 1013793264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY DALE COLLINS PIC/Owner 337-287-9599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2024-09-25 |