Organization
STEWART-JOHNSTON INC
Active
Other names
Family Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE MENZINA (OWNER)
(318) 259-7334
Entity
Organization
Contact information
Practice address
1231 FARMERVILLE HWY, RUSTON, LA 71270-3513
(318) 254-0244
(318) 255-2037
Mailing address
1231 FARMERVILLE HWY, RUSTON, LA 71270-3513
(318) 254-0244
(318) 255-2037
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336H0001X
Home Infusion Therapy Pharmacy
6019IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1934098
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/25/2008
Last updated
02/21/2019
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