Organization
POINCIANA CLINIC PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY SOILEAU PHRM (OWNER)
(337) 468-5001
Entity
Organization
Contact information
Practice address
1508 CAJUN DR, STE A, MAMOU, LA 70554-2400
(337) 468-5001
(337) 468-5102
Mailing address
1508 CAJUN DR, STE A, MAMOU, LA 70554-2400
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
1688RI
LA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1253634
—
LA
01
—
1918981
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/21/2006
Last updated
09/11/2025
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