| NPI | 1073625927 |
|---|---|
| Doing Business As | ICARE PHARMACY - JOHNSTON ST, LLC |
| Entity Type | Organization |
| Authorized Contact | CLEVELAND MICHAUD Owner 337-233-4782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY006927IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-07-19 |