| NPI | 1326409616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC PETERS Owner 225-647-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 7285) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2018-03-17 |