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General NPI Number Information
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NPI Number | 1013110246
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Entity Type | Organization
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Legal Business Name | PHARMACY CITY LLC
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 3805 JEFFERSON HWY
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City | JEFFERSON
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State | LA
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Zip | 70121-1625
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Country | US
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Telephone | 504-834-2525
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Fax | 504-834-2515
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Provider Business Mailing Address
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Address Line | 3805 JEFFERSON HWY
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City | JEFFERSON
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State | LA
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Zip | 70121-1625
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TODD REYNOLDS
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Credential | PHRMD
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Telephone | 504-828-1606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5814IR
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License Number State | LA
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