| NPI | 1619385812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE PRIMEAUX Owner/Manager 337-806-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: LA PHY006937IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2020-12-17 |