| NPI | 1265538664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RICHARD GRAY PIC 318-429-0161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: LA 5223) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 5223) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2025-06-11 |