# CENTRAL DRUG STORE INC

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

## Provider details

- **NPI number:** 1578115143
- **Authorized official:** JILL WHITE MILLER (MANAGER)
- **Authorized official phone:** (225) 262-6200

## Contact information

- **Practice address:** 9952 SULLIVAN RD, BATON ROUGE, LA 70818-4300
- **Practice address phone:** (225) 262-6200
- **Practice address fax:** (225) 262-6578
- **Mailing address:** 9952 SULLIVAN RD, BATON ROUGE, LA 70818-4300
- **Mailing address phone:** (225) 262-6200
- **Mailing address fax:** (225) 262-6578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |
| 314000000X | Skilled Nursing Facility | — | NULL | — |

## Other

- **Enumeration date:** 07/12/2019
- **Last updated:** 07/15/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1265926 | — | LA |