# MABILES CORNER PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MABILES CORNER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528141157
- **Authorized official:** CONNIE MABILE (PRES)
- **Authorized official phone:** (318) 932-5727

## Contact information

- **Practice address:** 100 GULF ST, COUSHATTA, LA 71019-9014
- **Practice address phone:** (318) 932-5727
- **Practice address fax:** (318) 932-5630
- **Mailing address:** PO BOX 609, COUSHATTA, LA 71019-0609

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY-004694-IR | LA | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/24/2006
- **Last updated:** 08/09/2019