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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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