Organization
VITAL CARE OF MISS-LOU, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E MAIER RPH (OWNER)
(318) 757-8711
Entity
Organization
Contact information
Practice address
131 DOCTORS DR, FERRIDAY, LA 71334-2251
(318) 757-8711
(318) 757-8716
Mailing address
PO BOX 1757, FERRIDAY, LA 71334-1757
(318) 757-8711
(318) 757-8716
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PHY007013IR
LA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
PHY007013IR
LA
3336C0003X
Community/Retail Pharmacy
Primary
PHY007013IR
LA
3336C0004X
Compounding Pharmacy
PHY007013IR
LA
3336H0001X
Home Infusion Therapy Pharmacy
PHY007013IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2200551
—
LA
Enumeration date
03/13/2015
Last updated
03/13/2015
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