Individual
DENICE GORDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
3670 W OAK ST, JENA, LA 71342-4474
(318) 992-1357
(318) 992-1359
Mailing address
1647 HIGHWAY 124 E, KELLY, LA 71441-2028
(318) 495-3558
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
016016
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1346267614
NPI
—
Enumeration date
07/18/2018
Last updated
07/18/2018
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