Organization
ELMHS OUTPATIENT PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY DOLESE R.PH (PHARMACY DIRECTOR)
(225) 634-0370
Entity
Organization
Contact information
Practice address
4502 HWY 951, BUILDING 200 NORTH, JACKSON, LA 70748-0498
(225) 634-0368
(225) 634-0447
Mailing address
PO BOX 498, JACKSON, LA 70748-0498
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
006272
LA
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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