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Organization
OUR LADY OF GUADALUPE PHARMACY
Active
Organization
OUR LADY OF GUADALUPE PHARMACY
Active
Other names
OUR LADY OF GUADALUPE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN LEE OWNER (OWNER)
(337) 826-9810
Entity
Organization
Contact information
Practice address
904 HIGHWAY 363, WASHINGTON, LA 70589-4141
(337) 826-9810
(337) 826-9813
Mailing address
904 HIGHWAY 363, WASHINGTON, LA 70589-4141
(337) 826-9810
(337) 826-9813
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY005564IR
LA
3336C0004X
Compounding Pharmacy
—
NULL
3336M0002X
Mail Order Pharmacy
—
NULL
Other
Enumeration date
10/23/2006
Last updated
03/15/2017
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