Organization
CENLA PROFESSIONAL PHARMACY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGIE STOCKTON RPH (CO OWNER)
(318) 442-3282
Entity
Organization
Contact information
Practice address
610 MAIN STREET, PINEVILLE, LA 71360
(318) 442-3282
(318) 442-2233
Mailing address
610 MAIN STREET, PINEVILLE, LA 71360
(318) 442-3282
(318) 442-2233
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1261360
—
LA
01
—
1925013
NABP
LA
01
—
52896
BLUE CROSS BLUE SHIELD
LA
Enumeration date
08/15/2006
Last updated
04/03/2013
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