Provider First Line Business Practice Location Address:
2418 S UNION ST
Provider Second Line Business Practice Location Address:
ATTENTION PHARMACY DEPT
Provider Business Practice Location Address City Name:
OPELOUSAS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70570-5735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-942-3674
Provider Business Practice Location Address Fax Number:
337-948-7560
Provider Enumeration Date:
11/15/2006