Organization
ST MARY PHARMACY LLC
Active
Other names
ST MARY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE RUSSO (PHARMACIST)
(985) 384-1234
Entity
Organization
Contact information
Practice address
1124 7TH ST, MORGAN CITY, LA 70380-1951
(985) 384-1234
(985) 384-1233
Mailing address
PO BOX 3230, MORGAN CITY, LA 70381-3230
(985) 384-1234
(985) 384-1233
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6396-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2131119
PK
—
05
—
2200887
—
LA
Enumeration date
08/02/2011
Last updated
02/14/2017
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