Organization
CASSIDYS PHARMACY INC
Active
Other names
CASSIDYS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLEN CASSIDY RPH (PRESIDENT)
(337) 824-1648
Entity
Organization
Contact information
Practice address
710 N MAIN ST, JENNINGS, LA 70546-5312
(337) 824-1648
(337) 824-6440
Mailing address
PO BOX 957, JENNINGS, LA 70546-0957
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY003337
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1263311
—
LA
01
—
2028757
PK
—
Enumeration date
10/24/2006
Last updated
12/08/2015
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