Organization
CPS DRUG STORE LLC
Active
Other names
CP's Drug Store LLC
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES PEPE (PRESIDENT/PHARMACIST)
(985) 732-0444
Entity
Organization
Contact information
Practice address
426 AVENUE B, BOGALUSA, LA 70427-3710
(985) 732-0444
(985) 735-9513
Mailing address
426 AVENUE B, BOGALUSA, LA 70427-3710
(985) 732-0444
(985) 735-9513
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006243-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1935064
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/10/2010
Last updated
12/29/2010
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