Organization
PHARMACY CITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD REYNOLDS (OWNER)
(504) 828-1606
Entity
Organization
Contact information
Practice address
1201 ROBERT BLVD, SLIDELL, LA 70458-2015
(985) 643-0087
(985) 643-0074
Mailing address
1201 ROBERT BLVD, SLIDELL, LA 70458-2015
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5640
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234249
—
LA
01
—
1933313
OTHER ID NUMBER
—
Enumeration date
04/03/2007
Last updated
09/13/2007
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