| NPI | 1366739369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY MENGARELLI Pharmacist In Charge 337-948-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 6398) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: LA 6398) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-06-29 |