| NPI | 1295166254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN GOOD Owner 318-255-8106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2021-12-16 |