| NPI | 1932615820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORLANDO PALMER Pharmacist In Charge 225-960-2444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: LA PHY.007561-IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2019-06-11 |