| NPI | 1730660697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS KEITH THIBODEAUX Special Projects Coordinator 337-948-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2018-12-19 |