| NPI | 1942307780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY T. NASH Pharmacy Manager 337-433-1429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 006031) |
| Additional Taxonomies | 3336L0003X Pharmacy, Long Term Care Pharmacy |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 6031IR) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2011-07-13 |