| NPI | 1568789063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY N MENGARELLI Owner 337-945-3567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-11-15 |