Organization
S MART ENTERPRISES INC
Active
Other names
FASULLO DRUGS
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA BERGERON (STORE MANAGER)
(504) 347-5458
Entity
Organization
Contact information
Practice address
905 WESTBANK EXPY, WESTWEGO, LA 70094-4652
(504) 347-5458
(504) 347-5449
Mailing address
PO BOX 427, WESTWEGO, LA 70096-0427
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
002368IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1259349
—
LA
01
—
1923879
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
03/05/2010
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