| NPI | 1982791174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUGUST COURVILLE Owner/PIC 337-580-1485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: LA PHY006500) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2006-10-07 |
| Last Update Date | 2016-09-28 |