Organization
WATERPROOF DRUGS INC
Active
Other names
COLVINS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLAIM COLVIN (OWNER)
(318) 757-4114
Entity
Organization
Contact information
Practice address
114 SERIO BLVD, FERRIDAY, LA 71334-2013
(318) 757-4114
(318) 757-4111
Mailing address
PO BOX 669, FERRIDAY, LA 71334-0669
(318) 757-4114
(318) 757-4111
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.001842-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1254932
—
LA
01
—
2031236
PK
—
Enumeration date
08/31/2006
Last updated
01/10/2014
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