# HAYDELS DRUG STORE \#3

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

## Provider details

- **NPI number:** 1518395755
- **Authorized official:** MR. ROBERT PAUL ROCK RPH (PHARMACIST)
- **Authorized official phone:** (985) 879-2440

## Contact information

- **Practice address:** 4752 HIGHWAY 311, SUITE 100, HOUMA, LA 70360-2810
- **Practice address phone:** (985) 879-2440
- **Practice address fax:** (985) 879-2967
- **Mailing address:** 4752 HWY 311, SUITE \#100, HOUMA, LA 70360
- **Mailing address phone:** (985) 879-2440
- **Mailing address fax:** (985) 879-2967

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 10582 | LA | Yes |

## Other

- **Enumeration date:** 10/25/2013
- **Last updated:** 10/25/2013