| NPI | 1356743751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC ANTHONY PETERS Owner 225-402-4084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 006957) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2022-07-11 |