| NPI | 1013994490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN BREAUX President 985-385-1864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 24821R) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2010-08-16 |