Organization
LAA DRUG LLC
Active
Other names
WILSON DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH ALLEN PHRMD (MANG MEMBER)
(978) 279-2173
Entity
Organization
Contact information
Practice address
118 W 4TH ST, HEARNE, TX 77859-2506
(979) 279-2173
(979) 279-2983
Mailing address
118 W 4TH ST, HEARNE, TX 77859-2506
(979) 279-2173
(979) 279-2983
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25895
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2097010
PK
—
Enumeration date
07/30/2006
Last updated
06/08/2015
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