Organization
SMOTHERMAN INC
Active
Other names
URANIA DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MARYKAY NORTH PD (OWNER)
(318) 495-5915
Entity
Organization
Contact information
Practice address
2164 E HARDNTER DR, URANIA, LA 71480
(318) 495-5407
(318) 495-5421
Mailing address
PO BOX 640, URANIA, LA 71480-0640
(318) 495-5407
(318) 495-5421
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY001516IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1251909
—
LA
01
—
1917270
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/24/2007
Last updated
08/09/2011
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