Organization
MEDICINE PRO LLC
Active
Other names
MED-PRO PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CYRENA JACKSON (OWNER/PIC)
(504) 234-1056
Entity
Organization
Contact information
Practice address
2600 S CLAIBORNE AVE, NEW ORLEANS, LA 70125-3921
(504) 309-9223
(504) 309-7264
Mailing address
659 RUE SAINT MICHAEL, TERRYTOWN, LA 70056-8224
(504) 234-1056
(504) 393-7549
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6523
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2135400
PK
—
05
—
2201450
—
LA
Enumeration date
03/21/2012
Last updated
04/19/2017
Update your record
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