Organization
BOUDREAUX'S NEW DRUG STORE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUG BOUDREAUX (OWNER)
(318) 631-2005
Entity
Organization
Contact information
Practice address
404 E. PRIEN LAKE RD, LAKE CHARLES, LA 70601
(337) 436-7216
(337) 436-7217
Mailing address
2551 GREENWOOD RD, SUITE 110, SHREVEPORT, LA 71103-3981
(318) 631-2005
(318) 631-1883
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4537-IR
LA
Other
Enumeration date
03/02/2007
Last updated
02/08/2013
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