# MEDIC PHARMACY OF BASTROP INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386703411
- **Authorized official:** MR. WILLIAM GARY GRAYSON R.PH. (OWNER)
- **Authorized official phone:** (318) 665-4414

## Contact information

- **Practice address:** 601 HIGHWAY 2, STERLINGTON, LA 71280-3002
- **Practice address phone:** (318) 665-4414
- **Practice address fax:** (318) 665-0770
- **Mailing address:** 601 HIGHWAY 2, STERLINGTON, LA 71280-3002
- **Mailing address phone:** (318) 665-4414
- **Mailing address fax:** (318) 665-0770

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 4116IR | LA | Yes |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 02/12/2014