| NPI | 1790732220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD D. STELLY President 337-233-1307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: LA 5205-IR) |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: LA 5205-IR) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: AL 201323) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: AL 112590) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: AR 0S01623) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: MS 06399 / 07.1) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: MS 06981 / 11.1) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: TX 23750) | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: WV MO0559823) | |
| Enumeration Date | 2006-05-29 |
| Last Update Date | 2018-08-22 |