Organization
LAKE AREA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN SCOTT CLOUD RPH (DIRECTOR OF PHARMACY)
(337) 721-1931
Entity
Organization
Contact information
Practice address
1004 FORTUNE RD STE 6, YOUNGSVILLE, LA 70592-5793
(337) 450-3052
(337) 450-3053
Mailing address
1004 FORTUNE RD STE 6, YOUNGSVILLE, LA 70592-5793
(337) 450-3052
(337) 450-3053
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5129-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1271080
—
LA
Enumeration date
12/11/2006
Last updated
09/09/2022
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