Organization
SENIOR SCRIPT PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL T MAHFOUZ (MANAGING MEMBER)
(318) 443-9195
Entity
Organization
Contact information
Practice address
26737 LA HIGHWAY 1032, DENHAM SPRINGS, LA 70726-4926
(318) 443-9195
Mailing address
1412 CENTRE CT, SUITE 503, ALEXANDRIA, LA 71301-3400
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
PHY.007501-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2205331
—
LA
Enumeration date
04/18/2017
Last updated
09/25/2017
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