Organization
KIRBY PHARMACY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIRBY BONVILLAIN (PHARMACIST)
(985) 853-2885
Entity
Organization
Contact information
Practice address
7505 MAIN ST, HOUMA, LA 70360-4223
(985) 853-2885
(985) 853-2091
Mailing address
7505 MAIN ST, HOUMA, LA 70360-4223
(985) 853-2885
(985) 853-2091
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
6100-IR
LA
3336C0004X
Compounding Pharmacy
Primary
6100-IR
LA
3336S0011X
Specialty Pharmacy
6100-IR
LA
Other
Enumeration date
01/29/2007
Last updated
06/02/2009
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