| NPI | 1548564677 |
|---|---|
| Doing Business As | WILLOW BARK PHARMACY |
| Entity Type | Organization |
| Authorized Contact | MINH NGUYEN President 985-876-5502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY.006362-IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2016-11-18 |