| NPI | 1063572428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MICHAEL FOSTER Staff Pharmacist 318-387-9677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 4889-IR) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2022-04-04 |