Organization
GORDON DRUG STORE INC
Active
Other names
GORDONS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE LOCKPARET RPH (OWNER)
(337) 477-6773
Entity
Organization
Contact information
Practice address
2716 LAKE ST, LAKE CHARLES, LA 70601-8216
(337) 477-6773
(337) 477-7126
Mailing address
PO BOX 1180, LAKE CHARLES, LA 70602-1180
(337) 477-6773
(337) 477-7126
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.000427-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2028780
PK
—
Enumeration date
07/26/2005
Last updated
06/10/2015
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