| NPI | 1164829891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN MATHERNE LANTRIP Compounding Pharmacist 985-345-5120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: LA PST.011783) |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2023-03-07 |