Organization
CENTRAL REXALL DRUGS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAN MATHERNE LANTRIP PD (COMPOUNDING PHARMACIST)
(985) 345-5120
Entity
Organization
Contact information
Practice address
125 E THOMAS ST, HAMMOND, LA 70401-3313
(985) 345-5120
(985) 345-5178
Mailing address
125 E THOMAS ST, HAMMOND, LA 70401-3313
(985) 345-5120
(985) 345-5178
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.011783
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1207900
MEDICAID
LA
01
—
1639165491
NPI
LA
01
—
1905732
NABP
LA
Enumeration date
11/24/2014
Last updated
03/07/2023
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