| NPI | 1184798563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN VIAL Owner 985-785-6213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 1119IR) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |