Organization
BROOKSHIRES GROCERY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ASHLEY NICOLE SLOCUM PHARM.D. (PHARMACIST)
(318) 687-7558
Entity
Organization
Contact information
Practice address
388 BERT KOUNS LOOP, SHREVEPORT, LA 71106-8123
(318) 687-7558
Mailing address
388 BERT KOUNS LOOP, SHREVEPORT, LA 71106-8123
(318) 687-7558
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
019518
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1628
MEDICATION ADMINISTRATION NUMBER
LA
Enumeration date
09/16/2011
Last updated
10/14/2011
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