| NPI | 1912326968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA TERESA W ANDREPONT Managing Officer 337-233-4782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-08-01 |