Organization
PROFESSIONAL PLAZA PHARMACY INC
Active
Other names
PRESCRIPTION PAD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BROOKE LE RPH (OWNER)
(504) 393-7734
Entity
Organization
Contact information
Practice address
120 MEADOWCREST ST, STE 150, GRETNA, LA 70056-5255
(504) 393-7733
(504) 391-7336
Mailing address
120 MEADOWCREST ST, STE 150, GRETNA, LA 70056-5255
(504) 393-7733
(504) 391-7336
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.005443-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1272108
—
LA
01
—
2031945
PK
—
Enumeration date
12/28/2006
Last updated
12/10/2015
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