| NPI | 1942350269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GIL BIRCH Owner 318-255-3318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: LA 002317) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2020-08-22 |