| NPI | 1821393653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PAUL BROWN Pharmacist In Charge 318-484-2773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 5667-CH) |
| Enumeration Date | 2011-01-26 |
| Last Update Date | 2011-01-26 |