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Organization

NDD LLC

Active
Other names
North Desoto Drug
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA DOMINGUEZ (OWNER)
(318) 775-4371
Entity
Organization

Contact information

Practice address
316 PLANTATION HILLS BLVD STE A, STONEWALL, LA 71078-2838
(318) 775-4371
(318) 775-4369
Mailing address
316 PLANTATION HILLS BLVD STE A, STONEWALL, LA 71078-2838
(318) 775-4371
(318) 775-4369

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006948-IR
LA
3336L0003X
Long Term Care Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2147912
PK
05
2203061
LA
Enumeration date
09/11/2014
Last updated
09/30/2022
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