Organization
PORT ALLEN SUPERMARKET INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD INKROTT RPH (PHARMACIST)
(225) 343-7855
Entity
Organization
Contact information
Practice address
220 N ALEXANDER AVE, PORT ALLEN, LA 70767-2514
(225) 343-7855
(225) 344-4197
Mailing address
220 N ALEXANDER AVE, PORT ALLEN, LA 70767-2514
(225) 343-7855
(225) 344-4197
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
003541IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1926394
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
1926394
—
LA
Enumeration date
07/22/2006
Last updated
06/19/2008
Update your record
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