Organization
SOUTHEAST LOUISIANA WAR VETERANS HOME
Active
Other names
Southeast Louisiana War Veterans Home
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BECNEL (PHARMACISTS-IN-CHARGE)
(985) 479-4080
Entity
Organization
Contact information
Practice address
4080 W AIRLINE HWY, RESERVE, LA 70084-5712
(985) 479-4080
(985) 479-4091
Mailing address
4080 W AIRLINE HWY, RESERVE, LA 70084-5712
(985) 479-4080
(985) 479-4091
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY005821
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153438
PK
—
Enumeration date
08/07/2015
Last updated
08/07/2015
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