| NPI | 1851792824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BREANNA NEWTON Pharmacy Supervisor 337-377-7213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: LA pst.020613) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |