Organization
NORTHSIDE FAMILY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY SCOTT MAPLES (PRESIDENT)
(225) 664-9520
Entity
Organization
Contact information
Practice address
850 COCKERHAM RD, DENHAM SPRINGS, LA 70726-2645
(225) 664-9520
(225) 664-5769
Mailing address
850 COCKERHAM RD, DENHAM SPRINGS, LA 70726-2645
(225) 664-9520
(225) 664-5769
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11338
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1264130
—
LA
Enumeration date
10/09/2006
Last updated
08/22/2020
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