| NPI | 1578317913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA L ROBERIE Credentialing 337-942-8911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-12 |