| NPI | 1932207081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERMIT LAMAR WALTERS President 318-388-1374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 2328IR) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |