Organization
TASDA PROPERTIES, LLC
Active
Other names
Ideal Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES RANDALL STAFFORD II (OWNER)
(985) 839-4668
Entity
Organization
Contact information
Practice address
808 RIVERSIDE DR, FRANKLINTON, LA 70438-3634
(985) 839-4668
(985) 207-4670
Mailing address
PO BOX 771, FRANKLINTON, LA 70438-0771
(985) 839-4668
(985) 207-4670
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.007688-I
LA
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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