Organization
CLINTON DRUGSTORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY ROSS COCKRELL P.D. (PHARMACIST)
(225) 683-9805
Entity
Organization
Contact information
Practice address
1027 ST HELENA, CLINTON, LA 70722-1027
(225) 683-9805
Mailing address
PO BOX 209, CLINTON, LA 70722
(225) 683-9805
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
185 IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1209449
—
LA
Enumeration date
05/08/2007
Last updated
10/06/2009
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