| NPI | 1649331661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHARLES SAHUC Pharmacist In Charge 1504-305-4350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 5199-IR) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |