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Organization
SOUTHLAND DRUGS NO 2 INC
Active
Organization
SOUTHLAND DRUGS NO 2 INC
Active
Other names
SOUTHLAND DRUGS #2
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY GUILLOT RPH (PRESIDENT)
(985) 447-5852
Entity
Organization
Contact information
Practice address
1117 AUDUBON AVE, THIBODAUX, LA 70301-4940
(985) 447-5852
(985) 447-4484
Mailing address
1117 AUDUBON AVE, THIBODAUX, LA 70301-4940
(985) 447-5852
(985) 447-4484
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY.001493-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1251542
—
LA
01
—
1902231
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/11/2007
Last updated
04/09/2024
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