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General NPI Number Information
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NPI Number | 1164704102
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Entity Type | Organization
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Legal Business Name | RACELANDS EXPRESS LLC
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 4634 HIGHWAY 1 STE B
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City | RACELAND
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State | LA
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Zip | 70394-2623
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Country | US
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Telephone | 985-537-3303
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Fax | 985-537-3393
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Provider Business Mailing Address
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Address Line | 6 TEAL CT
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City | WESTWEGO
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State | LA
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Zip | 70094-5070
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Country | US
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Telephone | 504-296-7428
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | VINCENT BUI
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Credential |
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Telephone | 504-296-7428
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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 | PHY.006419-IR
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License Number State | LA
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