Organization
WEST LOUISIANA HEALTH SERVICES INC
Active
Other names
Beauregard Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRE MANITZAS PHARMD (DIRECTOR OF PHARMACY)
(337) 462-7172
Entity
Organization
Contact information
Practice address
600 S PINE ST, DERIDDER, LA 70634-4942
(337) 462-7172
(337) 462-7328
Mailing address
600 S PINE ST, DERIDDER, LA 70634-4942
(337) 462-7172
(337) 462-7328
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
001311
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912559
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/14/2010
Last updated
04/14/2010
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