| NPI | 1922017508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHEL RAY LACROIX Vice President 318-619-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 4444) |
| Additional Taxonomies | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: LA 4444) |
| 3336S0011X Pharmacy, Specialty Pharmacy (Licence: LA 4444) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2023-03-07 |