Organization
LOURDES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDMOND DUCOTE (OWNER)
(318) 256-3426
Entity
Organization
Contact information
Practice address
220 HIGHLAND DR, STE E, MANY, LA 71449-3764
(318) 256-3426
(318) 256-0101
Mailing address
220 HIGHLAND DR, STE E, MANY, LA 71449-3764
(318) 256-3426
(318) 256-0101
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.001872-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255190
—
LA
01
—
2177268
PK
—
Enumeration date
06/04/2018
Last updated
10/23/2018
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