| NPI | 1093439051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN TABOR Director Of Pharmacy 318-408-2450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2024-09-10 |