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Organization

LIFEWAY PHARMACY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERICA SULLIVAN DITTA PHARMD (OWNER/PHARMACIST IN CHARGE)
(318) 355-3202
Entity
Organization

Contact information

Practice address
1822 TOWER DR, MONROE, LA 71201-4938
(318) 323-5483
(318) 323-5485
Mailing address
1822 TOWER DR, MONROE, LA 71201-4938
(318) 323-5483
(318) 323-5485

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
017373
LA

Other

Enumeration date
01/10/2012
Last updated
01/10/2012
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