Individual
SUSAN AYCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
817 W MAIN ST, HOMER, LA 71040-3322
(318) 927-3537
(318) 927-6400
Mailing address
817 W MAIN ST, HOMER, LA 71040-3322
(318) 927-3537
(318) 927-6400
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13783
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13783
PHARMACY LISENCE
LA
Enumeration date
08/23/2011
Last updated
08/23/2011
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