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General NPI Number Information
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NPI Number | 1033216874
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Entity Type | Organization
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Legal Business Name | MAGNOLIA PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 26 HEYMAN LN
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3523
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Country | US
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Telephone | 318-443-5810
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Fax | 318-443-6133
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Provider Business Mailing Address
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Address Line | PO BOX 11940
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City | ALEXANDRIA
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State | LA
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Zip | 71315-1940
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Country | US
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Telephone | 318-443-5810
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Fax | 318-443-6133
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Authorized Official
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Title or Position | CHIEF PHARMACIST
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Name | JAMES LOWERY
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Credential |
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Telephone | 318-443-5810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 4392IR
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License Number State | LA
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