| NPI | 1831505536 |
|---|---|
| Doing Business As | JEFFERSON DRUG STORE |
| Entity Type | Organization |
| Authorized Contact | JOHN D BAQUE Owner/Pharmacist 337-234-1428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 11850) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2014-07-02 |