Organization
WILEYS PHARMACY AND COMPOUNDING SERVICE INC
Active
Other names
MASONS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA WILEY RPH (SECRETARY)
(318) 396-1812
Entity
Organization
Contact information
Practice address
2403 ARKANSAS RD, WEST MONROE, LA 71291-8611
(318) 396-1812
(318) 396-5602
Mailing address
2403 ARKANSAS RD, WEST MONROE, LA 71291-8611
(318) 396-1812
(318) 396-5602
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
PHY.005903-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1250571
—
LA
01
—
1916090
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/16/2006
Last updated
02/03/2016
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