| NPI | 1669871638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE PATRICK WATTS Pharmacist 985-860-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 012019) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2014-08-15 |