| NPI | 1508095407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENA PARKER Owner/PIC 225-275-2425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: LA 6148) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2009-09-25 |