| NPI | 1073528626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LURTHIE LEATHAMAN Pharm Admin 225-763-6259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 5581) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |