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Organization
VITAL RX OF LOUISIANA LLC
Active
Organization
VITAL RX OF LOUISIANA LLC
Active
Other names
VitalRx of Louisiana
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH TATE (DIRECTOR)
(337) 304-9342
Entity
Organization
Contact information
Practice address
6200 LESLIE LANE, LAKE CHARLES, LA 70615-4772
(877) 264-8060
(888) 811-4564
Mailing address
6200 LESLIE LANE, LAKE CHARLES, LA 70615-4772
(877) 264-8060
(888) 811-4564
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY007506-IR
LA
Other
Enumeration date
08/01/2017
Last updated
02/22/2022
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