Organization
KELLY PHARMACY INC KELLY PHARMACY & GIFTS
Active
Other names
KELLY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK BOGGS RPH (PRESIDENT)
(318) 326-4229
Entity
Organization
Contact information
Practice address
302 E PALMETTO, PLAIN DEALING, LA 71064
(318) 326-4229
(318) 326-5903
Mailing address
PO BOX 188, PLAIN DEALING, LA 71064-0188
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.002188-IR
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121851407
—
AR
05
—
1258105
—
LA
01
—
2029118
PK
—
Enumeration date
10/03/2006
Last updated
10/27/2020
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