Organization
NIELSEN'S CITY DRUG STORE, INC
Active
Other names
NIELSENS CITY DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN NIELSEN (OWNER)
(985) 732-2561
Entity
Organization
Contact information
Practice address
330 AUSTIN ST, BOGALUSA, LA 70427-3818
(985) 732-2562
(985) 732-3421
Mailing address
330 AUSTIN ST, BOGALUSA, LA 70427-3818
(985) 732-2561
(985) 732-3421
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.000821-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1231398
—
LA
01
—
2028619
PK
—
Enumeration date
01/30/2007
Last updated
04/04/2017
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