| NPI | 1417026360 |
|---|---|
| Doing Business As | BROADMOOR DRUG CENTER |
| Entity Type | Organization |
| Authorized Contact | DEAN PELLEGRIN Owner Phcst 985-876-2584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 100IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2018-07-19 |