| NPI | 1154015220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN LOVE Pharmacist In Charge 318-387-8933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2023-06-02 |
| Last Update Date | 2023-10-24 |