| NPI | 1356834030 |
|---|---|
| Doing Business As | IDEAL PHARMACY |
| Entity Type | Organization |
| Authorized Contact | JAMES RANDALL STAFFORD Owner 985-839-4668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.007688-I) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2018-06-07 |