| NPI | 1396237475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND DUCOTE Owner 318-256-3426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.001872-IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2018-10-23 |