| NPI | 1598334641 |
|---|---|
| Doing Business As | BLAKES SOUTHSIDE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | IVAN JOE LANDRY Owner/PIC 337-363-7497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2021-06-23 |
| Last Update Date | 2025-06-10 |