| NPI | 1346071461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLYNDA FUSELIER Managing Member 318-715-0015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 3336L0003X Pharmacy Long Term Care Pharmacy |
| Enumeration Date | 2024-08-10 |
| Last Update Date | 2024-09-23 |