Organization
EARL K LONG MEDICAL CENTER
Active
Other names
EARL K LONG MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI LEE (PHARMACY DIRECTOR)
(225) 358-4826
Entity
Organization
Contact information
Practice address
5825 AIRLINE HWY, BATON ROUGE, LA 70805-2408
(225) 358-4826
(225) 358-4827
Mailing address
EKLMC-OUT PHARMACY, 5825 AIRLINE HWY, BATON ROUGE, LA 70805
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336I0012X
Institutional Pharmacy
Primary
PHY.004380-IRX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1203831
—
LA
01
—
1914820
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/11/2006
Last updated
02/13/2013
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