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Organization

REEVES DRUG STORE INC

Active
Other names
REEVES DRUG STORE
Organization subpart
No

Provider details

NPI number
Authorized official
GARY FARMER (PRESIDENT)
(318) 336-5112
Entity
Organization

Contact information

Practice address
307 CARTER ST, VIDALIA, LA 71373-3305
(318) 336-5112
(318) 336-9745
Mailing address
307 CARTER ST, VIDALIA, LA 71373-3396
(318) 336-5112
(318) 336-9745

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
PHY.003525-IR
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00330273
MS
05
1264083
LA
01
2028314
PK
Enumeration date
11/01/2006
Last updated
09/19/2025
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