Organization
WINN- DIXIE MONTGOMERY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONICA A DOMINIQUE GOODEN (PHARMACIST)
(504) 437-0541
Entity
Organization
Contact information
Practice address
3001 HIGHWAY 90 W, AVONDALE, LA 70094-2758
(504) 437-0541
Mailing address
120 RIVERLANDS DR, LA PLACE, LA 70068-7106
(985) 651-0947
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15427
LA
Other
Enumeration date
09/29/2006
Last updated
08/22/2020
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