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Organization

THE BERNICE PHARMACY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRANDON K KEASTER PHARM. D (PIC)
(318) 285-9521
Entity
Organization

Contact information

Practice address
417 MAIN ST, BERNICE, LA 71222
(318) 285-9521
(318) 285-0185
Mailing address
PO BOX 636, BERNICE, LA 71222-0636
(318) 285-9521
(318) 285-0185

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
Primary
006680IR
LA
3336L0003X
Long Term Care Pharmacy
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1904223
NABP
LA
05
2202090
LA
Enumeration date
09/28/2006
Last updated
06/22/2018
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