| NPI | 1164930335 |
|---|---|
| Doing Business As | LEGACY PHARMACY |
| Entity Type | Organization |
| Authorized Contact | DARRYL MONROE Managing Empoyee 318-445-0408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 007588) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |