| NPI | 1962432641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLY GRAN VP 318-686-9995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: LA 3763) |
| Additional Taxonomies | 3336H0001X Pharmacy Home Infusion Therapy Pharmacy |
| 3336L0003X Pharmacy Long Term Care Pharmacy | |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| 3336M0002X Pharmacy Mail Order Pharmacy | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2010-04-16 |