| NPI | 1285024323 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON LOUIS WILLIS Owner/Pharmacist 318-466-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.007057-IR) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2017-03-02 |