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Organization

WHITE'S COMPOUNDING PHARMACY, LLC

Active
Other names
Boudreaux's Specialty Compounding
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DOUG BOUDREAUX (OWNER)
(318) 631-2005
Entity
Organization

Contact information

Practice address
2551 GREENWOOD RD, SUITE 110, SHREVEPORT, LA 71103-3981
(318) 631-2005
(318) 631-1883
Mailing address
2551 GREENWOOD RD, SUITE 110, SHREVEPORT, LA 71103-3981
(318) 631-2005
(318) 631-1883

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
4242-IR
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1267171
LA
Enumeration date
12/22/2006
Last updated
01/28/2021
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