Organization
ROSEPINE FAMILY PHARMACY INC
Active
Other names
ROSEPINE FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW PETERSON (OWNER)
(337) 462-0177
Entity
Organization
Contact information
Practice address
18507 CENTRAL AVE, ROSEPINE, LA 70659
(337) 462-0177
(337) 462-0078
Mailing address
PO BOX 408, ROSEPINE, LA 70659-0408
(337) 462-0177
(337) 462-0078
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.002000-IR
LA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1256340
—
LA
01
—
2032133
PK
—
Enumeration date
08/18/2006
Last updated
07/11/2016
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