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Organization
WALTZ & BRAZZEL PHARMACY INC
Active
Organization
WALTZ & BRAZZEL PHARMACY INC
Active
Other names
Waltz Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHIL H WALTZ JR. RPH (OWNER REGISTERED PHARMACIST)
(318) 255-0458
Entity
Organization
Contact information
Practice address
200 NORTH TRENTON STREET, RUSTON, LA 71270
(318) 255-0458
(318) 251-3373
Mailing address
200 NORTH TRENTON STREET, RUSTON, LA 71270
(318) 255-0458
(318) 251-3373
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3935 1R
LA
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Enumeration date
02/01/2007
Last updated
03/25/2022
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