| NPI | 1073109633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE P PRIMEAUX Pharmacist In Charge 337-806-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2024-05-23 |