| NPI | 1962536458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY JON WENDLING Owner 985-641-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: LA 3721) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2020-08-22 |