Organization
LANDRY'S PHARMACY 1, LLC
Active
Other names
Landry's Pharmacy 1, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARVIS HARVEY (OWNER)
(504) 957-6784
Entity
Organization
Contact information
Practice address
416 N BURNSIDE AVE, GONZALES, LA 70737-2828
(504) 957-6784
Mailing address
416 N BURNSIDE AVE, GONZALES, LA 70737-2828
(504) 957-6784
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007878
LOUISIANA BOARD OF PHARMACY
LA
Enumeration date
06/25/2019
Last updated
02/27/2020
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