| NPI | 1619058468 |
|---|---|
| Doing Business As | SHREVEPORT NUCLEAR PHARMACY |
| Entity Type | Organization |
| Authorized Contact | STEPHEN RANDALL CAUDLE President/Owner 318-221-5114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA LA 3999-IR) |
| Additional Taxonomies | 3336N0007X Pharmacy, Nuclear Pharmacy (Licence: LA LA 4001-NU) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |