Organization
HEALTH MART OF JENNINGS LLC
Active
Other names
HEALTH MART PHARMACY OF JENNINGS
Organization subpart
No
Provider details
NPI number
Authorized official
WESLEY DAVID RPH (OWNER AND PRESIDENT)
(337) 616-9500
Entity
Organization
Contact information
Practice address
1322 ELTON RD, SUITE A, JENNINGS, LA 70546-4100
(337) 616-9500
(337) 616-9555
Mailing address
818 N CUSHING AVE, KAPLAN, LA 70548-2615
(337) 643-7952
(337) 643-7953
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.005639-IR
LA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1233994
—
LA
01
—
2035363
PK
—
Enumeration date
07/06/2006
Last updated
12/22/2015
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