Organization
SOUTHERN RX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAHUL PATEL (OWNER)
(337) 365-1411
Entity
Organization
Contact information
Practice address
1033 ANDRE ST, NEW IBERIA, LA 70563
(337) 365-1411
(337) 365-0932
Mailing address
1033 ANDRE ST, NEW IBERIA, LA 70563-2161
(337) 365-1411
(337) 365-0932
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
PHY007503IR
LA
3336C0003X
Community/Retail Pharmacy
Primary
PHY007503IR
LA
3336C0004X
Compounding Pharmacy
PHY007503IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2205498
—
LA
Enumeration date
10/07/2006
Last updated
01/15/2020
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