| NPI | 1801991757 |
|---|---|
| Doing Business As | INDEPENDENT COMMUNITY PHCY |
| Entity Type | Organization |
| Authorized Contact | VICTOR KOBLIN President 318-931-2133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: MI 5301003741) |
| Additional Taxonomies | 3336C0002X Pharmacy, Clinic Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |