| NPI | 1225800733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WITSCHEN BRYCE Manager 225-451-5804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336M0002X Pharmacy, Mail Order Pharmacy | |
| Enumeration Date | 2023-10-27 |
| Last Update Date | 2023-10-27 |