Organization
CHILDREN'S PHARMACY
Active
Parent organization
CHILDREN'S PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S PHARMACY
Authorized official
CHUCK K. SELF ADMINISTRATOR (ADMINISTRATOR)
(337) 478-6480
Entity
Organization
Contact information
Practice address
4111 LAKE ST, LAKE CHARLES, LA 70605-4305
(337) 502-4873
Mailing address
4111 LAKE ST, LAKE CHARLES, LA 70605-4305
(337) 502-4873
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY-007098-IR
LA
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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