| 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 |