Organization
LIVE OAK PHARMACY INC
Active
Other names
LIVE OAK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LUCILLE BABB RPH (OWNER)
(225) 664-7125
Entity
Organization
Contact information
Practice address
34730 LA HWY 16, WATSON, LA 70786
(225) 664-7125
(225) 664-7869
Mailing address
PO BOX 829, WATSON, LA 70786-0829
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY002119IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1257419
—
LA
01
—
2032220
PK
—
Enumeration date
01/03/2007
Last updated
05/27/2016
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