Organization
BLAKES SOUTHSIDE PHARMACY PHASE II LLC
Active
Other names
Blakes Southside Pharmacy INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM L FORET PHARMACIST (PIC ( PHARMACIST IN CHARGE))
(337) 363-7497
Entity
Organization
Contact information
Practice address
808 S. CHATAIGNIER RD, VILLE PLATTE, LA 70586
(337) 363-7497
(337) 363-0473
Mailing address
808 S. CHATAIGNIER RD, VILLE PLATTE, LA 70586
(337) 363-7497
(337) 363-0473
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10232
LA
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1252620
—
LA
Enumeration date
02/14/2007
Last updated
09/03/2020
Update your record
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