| NPI | 1427145614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL TYLER Business Manager 225-214-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: LA 013735) |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2007-09-13 |