| NPI | 1174573182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON REED Mging Officer Of Phcy 337-802-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 5651 IR) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2020-08-22 |