| NPI | 1689694507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI ALLEN Owner 318-442-4475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: LA 001670) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2013-04-16 |