| NPI | 1932481900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAITH KAMEL QAISI Pharmacist In Charge 318-869-3453 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: LA 18858) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |