NPI | 1073385506 |
---|---|
Entity Type | Organization |
Authorized Contact | STACI LEANN BRYCE Pharmacist In Charge 225-405-5418 |
Organization Subpart ? | No |
Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
3336H0001X Pharmacy, Home Infusion Therapy Pharmacy | |
3336M0002X Pharmacy, Mail Order Pharmacy | |
Enumeration Date | 2023-10-27 |
Last Update Date | 2023-10-27 |