Organization
KAR PHARMACY SERVICES, LLC
Active
Other names
Bourg's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN SOULIER (OPERATIONS MANAGER)
(225) 485-1049
Entity
Organization
Contact information
Practice address
484 LOUISIANA AVE, PORT ALLEN, LA 70767-2141
(225) 344-1077
(225) 344-4408
Mailing address
PO BOX 116, MARINGOUIN, LA 70757-0116
(225) 625-2353
(225) 625-3144
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
006877-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146546
PK
—
Enumeration date
09/30/2006
Last updated
10/29/2020
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