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General NPI Number Information
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NPI Number | 1336297381
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Entity Type | Organization
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Legal Business Name | DELTA DRUGS OF PORT SULPHUR LLC
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 27136 HIGHWAY 23
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City | PORT SULPHUR
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State | LA
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Zip | 70083-2648
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Country | US
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Telephone | 504-564-3141
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Fax | 504-301-0773
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Provider Business Mailing Address
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Address Line | 866 MARLENE DR
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City | GRETNA
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State | LA
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Zip | 70056-7642
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Country | US
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Telephone | 504-564-3141
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Fax | 504-301-0773
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Authorized Official
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Title or Position | PHARMACIST/OWNER/MGR
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Name | BROOKE H LE
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Credential | RPH
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Telephone | 504-905-3196
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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 | PHY005921IR
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License Number State | LA
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