Organization
PEARL RIVER RX INC
Active
Other names
Evans Drug Mart
Organization subpart
No
Provider details
NPI number
Authorized official
RAPHAEL MECHE (PRESIDENT)
(337) 334-3399
Entity
Organization
Contact information
Practice address
64288 HIGHWAY 41, PEARL RIVER, LA 70452-3602
(985) 863-3100
(985) 863-0790
Mailing address
PO BOX 578, RAYNE, LA 70578-0578
(337) 334-9979
(337) 334-9899
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006460-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133477
PK
—
Enumeration date
01/27/2012
Last updated
01/19/2017
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