Organization
BRODIE PHARMACY INC
Active
Other names
BRODIE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT ADAMS (MGR)
(318) 647-5754
Entity
Organization
Contact information
Practice address
204 DAVENPORT AVE, MER ROUGE, LA 71261
(318) 647-5754
(318) 647-5222
Mailing address
PO BOX 153, MER ROUGE, LA 71261-0153
(318) 647-5754
(318) 647-5222
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
000103IR
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205800
—
LA
01
—
1907510
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
07/19/2010
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