Organization
WILEYS PHARMACY & COMPOUNDING SERVICE INC
Active
Other names
Mason's Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH WILEY (PRESIDENT)
(318) 396-1812
Entity
Organization
Contact information
Practice address
2933 CYPRESS ST STE 2, WEST MONROE, LA 71291-5337
(318) 396-1812
(318) 396-5602
Mailing address
2403 ARKANSAS RD, WEST MONROE, LA 71291-8611
(318) 396-1812
(318) 396-5602
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY006288IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1935266
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/23/2010
Last updated
12/06/2010
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