Organization
BENNIE G. OWENS
Active
Other names
Headrick's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENNIE G OWENS (OWNER/PHARMACIST)
(318) 697-4381
Entity
Organization
Contact information
Practice address
204 MAIN ST, LOGANSPORT, LA 71049-2997
(318) 697-4381
(318) 697-5311
Mailing address
PO BOX 68, LOGANSPORT, LA 71049-0068
(318) 697-4381
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
452-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1219754
—
LA
01
—
1907116
NCPDP
—
05
—
580009
—
TX
Enumeration date
06/12/2017
Last updated
06/12/2017
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