# BROADMOOR DRUG CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BROADMOOR DRUG CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417026360
- **Authorized official:** DEAN PELLEGRIN PD (OWNER PHCST)
- **Authorized official phone:** (985) 876-2584

## Contact information

- **Practice address:** 6096 W PARK AVE, HOUMA, LA 70364-1808
- **Practice address phone:** (985) 876-2584
- **Practice address fax:** (985) 876-5050
- **Mailing address:** 6096 W PARK AVE, HOUMA, LA 70364-1797
- **Mailing address phone:** (985) 876-2584
- **Mailing address fax:** (985) 876-5050

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 100IR | LA | Yes |

## Other

- **Enumeration date:** 11/07/2006
- **Last updated:** 09/19/2025