| NPI | 1104873637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA MORRISON Certified Pharmacy Tech/Manager 225-654-3901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA LA1911-IR) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA LA1911-IR) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2025-09-11 |