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Organization

CITY APOTHECARY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN C HILDENBRAND PD (PRESIDENT)
(318) 388-4747
Entity
Organization

Contact information

Practice address
312 GRAMMONT ST, SUITE 102, MONROE, LA 71201-7457
(318) 388-4747
(318) 388-4849
Mailing address
312 GRAMMONT ST, SUITE 102, MONROE, LA 71201-7457
(318) 388-4747
(318) 388-4849

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
9945
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1208698
LA
01
38166
BLUE CROSS OF LA
LA
Enumeration date
01/22/2008
Last updated
01/22/2008
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