# SS BOSSIER CITY LLC

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

## Provider details

- **NPI number:** 1992758536
- **Authorized official:** GARY CHAD COLLINS (CEO)
- **Authorized official phone:** (214) 624-3050

## Contact information

- **Practice address:** 3501 SEVERN AVE STE 3A, STE 3A, METAIRIE, LA 70002-3459
- **Practice address phone:** (504) 889-8483
- **Practice address fax:** (504) 889-8487
- **Mailing address:** PO BOX 803493, DALLAS, TX 75380-3493
- **Mailing address phone:** (214) 624-3073
- **Mailing address fax:** (214) 989-7986

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 5538IR | LA | Yes |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 06/17/2014