| NPI | 1568510030 |
|---|---|
| Doing Business As | IDEAL HEALTH MART |
| Entity Type | Organization |
| Authorized Contact | KESA LANE Rph/Owner 337-463-7210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 006477) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2014-05-16 |