Organization
PROFESSIONAL PHARMACY OF WEST MONROE LOUISANA INC
Active
Other names
Professional Pharmacy of West Monroe
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY MITCHELL BS, PHARMACY (CHARGE RPH)
(318) 387-8933
Entity
Organization
Contact information
Practice address
101 PROFESSIONAL DR, WEST MONROE, LA 71291-8309
(318) 387-8933
(318) 387-0179
Mailing address
101 PROFESSIONAL DR, WEST MONROE, LA 71291-8309
(318) 387-8933
(318) 387-0179
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.001629-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1253162
—
LA
01
—
2030999
PK
—
Enumeration date
09/12/2006
Last updated
06/22/2016
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