Organization
JOHN BIRD
Active
Other names
Island Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN BIRD RPH (OWNER)
(318) 758-5533
Entity
Organization
Contact information
Practice address
311 CHISUM ST, SICILY ISLAND, LA 71368-4807
(318) 389-5807
(318) 389-5842
Mailing address
PO BOX 38, SICILY ISLAND, LA 71368-0038
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.6199-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235482
—
LA
01
—
2123508
PK
—
Enumeration date
01/15/2010
Last updated
11/14/2014
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