Organization
VILLAGE PHARMACY OF MER ROUGE INC
Active
Other names
VILLAGE PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BLACKWELL (CEO)
(318) 647-5786
Entity
Organization
Contact information
Practice address
308 DAVENPORT, MER ROUGE, LA 71261-0165
(318) 647-5786
(318) 647-3539
Mailing address
PO BOX 165, MER ROUGE, LA 71261-0165
(318) 647-5786
(318) 647-3539
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.001475-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1251313
—
LA
01
—
1918575
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/06/2006
Last updated
01/07/2011
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