NPI | 1124202486 |
---|---|
Entity Type | Organization |
Authorized Contact | BRYAN BIENVENU Doctor 225-767-1311 |
Organization Subpart ? | No |
Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: LA 022546) |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2007-12-21 |
Last Update Date | 2007-12-21 |