| NPI | 1952835753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL T MAHFOUZ Managing Member 318-443-9195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: LA PHY.007501-IR) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2017-04-18 |
| Last Update Date | 2017-09-25 |