| NPI | 1639579402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENT RAY ALLEN Owner 318-442-4475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 006929) |
| Enumeration Date | 2014-08-29 |
| Last Update Date | 2015-02-19 |