Organization
DE BLANC DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT L COUSINS RPH (OWNER)
(504) 949-8346
Entity
Organization
Contact information
Practice address
3111 GRAND RTE ST JOHN ST, NEW ORLEANS, LA 70119
(504) 949-8346
(504) 949-5146
Mailing address
3111 GRAND RTE ST JOHN ST, NEW ORLEANS, LA 70119
(504) 949-8346
(504) 949-5146
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
1618IR
LA
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1212245
—
LA
01
—
1908702
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/27/2006
Last updated
08/24/2010
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