Organization
C B & EMMA LLC
Active
Other names
STEWARTS DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
CLARENCE GOODREAU RPH (OWNER)
(337) 824-2311
Entity
Organization
Contact information
Practice address
403 W PLAQUEMINE ST, JENNINGS, LA 70546-5755
(337) 824-2311
(337) 824-2312
Mailing address
403 W PLAQUEMINE ST, JENNINGS, LA 70546-5755
(337) 824-2311
(337) 824-2312
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY.5660-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1906354
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/30/2006
Last updated
12/15/2011
About Stedi
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