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PBM SOLUTIONS COUSHATTA LLC

Suppliers Pharmacy Clinic Pharmacy

Provider NPI: 1548823370

Organization Information:
Organization Name:  PBM SOLUTIONS COUSHATTA LLC
Organization is not Subpart
Authorized Official:  PHILIPPE  PUCHEU  OWNER/MANAGER  337-738-4170

Practice Location:
287 PANTHER TRAIL DR  KINDER, LA 70648 US
Tel: 337-738-4170  Fax: 337-738-4171

Business Mailing Address:
287 PANTHER TRAIL DR  KINDER, LA 70648 US
Tel: 337-738-4170  Fax: 337-738-4171

NPI Information:
NPI: 1548823370
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y3336C0002XSuppliers
Pharmacy
Clinic Pharmacy

Other Provider Identifiers:

IssuerNumberStateType
DEAFC8268977LA01
LOUISIANA PHARMACY PERMIT007882LA01



American Medical Association 2012 taxonomy code information

Code: 3336C0002X

Type:

Classification:



Definition:



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