| NPI | 1760479117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN M DARTEZ President, Owner, PIC,AO 337-235-4578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA PHY-006091-IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2024-05-23 |