# PORT ALLEN SUPERMARKET INC

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

## Provider details

- **NPI number:** 1538180500
- **Authorized official:** RONALD INKROTT RPH (PHARMACIST)
- **Authorized official phone:** (225) 343-7855

## Contact information

- **Practice address:** 220 N ALEXANDER AVE, PORT ALLEN, LA 70767-2514
- **Practice address phone:** (225) 343-7855
- **Practice address fax:** (225) 344-4197
- **Mailing address:** 220 N ALEXANDER AVE, PORT ALLEN, LA 70767-2514
- **Mailing address phone:** (225) 343-7855
- **Mailing address fax:** (225) 344-4197

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 003541IR | LA | Yes |

## Other

- **Enumeration date:** 07/22/2006
- **Last updated:** 06/19/2008