Organization
SHAMROCK STREET PHARMACY
Active
Organization
SHAMROCK STREET PHARMACY
Active
Parent organization
CENTRAL LA STATE HOSPITAL
Other names
Central La State Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL LA STATE HOSPITAL
Authorized official
MR. JEFF S LINZAY REGISTERED PHARMACIS (PHARMACY DIRECTOR)
(318) 484-6665
Entity
Organization
Contact information
Practice address
242 WEST SHAMROCK STREET, UNIT 2, ROOM 120, PINEVILLE, LA 71360-6439
(318) 484-6665
(318) 484-6483
Mailing address
242 WEST SHAMROCK STREET, UNIT 2, ROOM 120, PINEVILLE, LA 71360-6439
(318) 484-6665
(318) 484-6483
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
PHY-006280-INX
LA
Other
Enumeration date
09/09/2010
Last updated
03/18/2011
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