| NPI | 1437542537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E MAIER Owner 318-757-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY007013IR) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA PHY007013IR) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: LA PHY007013IR) | |
| 3336C0004X Pharmacy, Compounding Pharmacy (Licence: LA PHY007013IR) | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: LA PHY007013IR) | |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2015-03-13 |