NPI: 1659417202 · INDEPENDENCE, LA 70443 · Long Term Care Pharmacy · NPI assigned 01/30/2007
| Authorized Official | CANNON, CHARLES (MANAGING MEMBER) |
| NPI Enumeration Date | 01/30/2007 |
| Year | Claims | Total Paid |
|---|---|---|
| 2021 | 12 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0012A | 12 | 12 | $0.00 |