| NPI | 1073518643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO RICHE PIC 318-487-1884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 14961) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2020-08-22 |