# PHOENIX REXALL DRUGS INC

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

## Provider details

- **NPI number:** 1609986116
- **Authorized official:** CYNTHIA WANN CPT (MANAGER)
- **Authorized official phone:** (337) 239-3421

## Contact information

- **Practice address:** 101 N 3RD ST, LEESVILLE, LA 71446-4013
- **Practice address phone:** (337) 239-3421
- **Practice address fax:** (337) 392-6212
- **Mailing address:** PO BOX 172, LEESVILLE, LA 71496-0172
- **Mailing address phone:** (337) 239-3421
- **Mailing address fax:** (337) 239-3422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 891IR | LA | Yes |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 09/02/2011