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General NPI Number Information
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NPI Number | 1174918783
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Entity Type | Organization
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Legal Business Name | USA PHARMACY & MEDICAL SUPPLIES
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 1170 HIGHWAY 44
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City | RESERVE
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State | LA
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Zip | 70084-5343
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Country | US
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Telephone | 985-536-0011
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Fax | 985-536-0012
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Provider Business Mailing Address
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Address Line | 1170 HIGHWAY 44
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City | RESERVE
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State | LA
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Zip | 70084-5343
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Country | US
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Telephone | 985-536-0011
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Fax | 985-536-0012
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Authorized Official
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Title or Position | OWNER
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Name | MR. MOHAMAD ESMAIL
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Credential |
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Telephone | 985-536-0011
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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 | 046147
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License Number State | LA
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