| NPI | 1255011474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN JAMES BOUDREAU Pharmacist In Charge 504-301-6638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2023-07-21 |
| Last Update Date | 2023-07-21 |