# CLINIC PHARMACY OF MANGHAM LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** CLINIC PHARMACY OF MANGHAM LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871553453
- **Authorized official:** KAYLA BRIDGES PD (OWNER/AO)
- **Authorized official phone:** (318) 248-3338

## Contact information

- **Practice address:** 252 HIGHWAY 132, MANGHAM, LA 71259-5268
- **Practice address phone:** (318) 248-3338
- **Practice address fax:** (318) 248-3399
- **Mailing address:** 252 HIGHWAY 132, MANGHAM, LA 71259-5268
- **Mailing address phone:** (318) 248-3338
- **Mailing address fax:** (318) 248-3399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY.006681-IR | LA | Yes |

## Other

- **Enumeration date:** 03/27/2006
- **Last updated:** 03/03/2016