Organization
LANDRY COLHAM LLC
Active
Other names
Brent's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT LANDRY (OWNER/PIC/AO)
(225) 332-0511
Entity
Organization
Contact information
Practice address
243 N ACADIAN THRUWAY STE 1, BATON ROUGE, LA 70806-3772
(225) 332-0511
(225) 332-5811
Mailing address
243 N ACADIAN THRUWAY STE 1, BATON ROUGE, LA 70806-3772
(225) 332-0511
(225) 332-5811
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006422
LA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132484
PK
—
05
—
2200950
—
LA
Enumeration date
09/23/2011
Last updated
07/19/2018
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