Organization
MARY BIRD PERKINS CANCER CENTER
Active
Other names
Mary Bird Perkins Pharmacy Minden
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA COURVILLE LEBLANC (CFO)
(225) 215-1321
Entity
Organization
Contact information
Practice address
10600 INDUSTRIAL DR STE B, MINDEN, LA 71055-5105
(318) 716-7541
(318) 202-8707
Mailing address
4950 ESSEN LN, BATON ROUGE, LA 70809-3738
(225) 215-1281
(225) 215-1380
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CDS.067595-PHY
PHARMACY CDS LICENSE
LA
01
—
PHY.008821-IR
PHARMACY LICENSE
LA
01
—
PIC.025224
PIC
LA
01
—
PST.025224
PIC
LA
Enumeration date
11/18/2019
Last updated
12/10/2024
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