| NPI | 1215345087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LYNN RILEY Pharmacist 504-421-2820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: LA PST.020646) |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |