| NPI | 1265675029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET M MENTESANE Executive Director 318-227-2912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 2441-CH) |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2009-04-09 |