NPI: 1972122349 · MOSS BLUFF, LA 70611 · Community/Retail Pharmacy · NPI assigned 04/15/2020
| Authorized Official | PETTIT, MICHAEL (OWNER/PHARMACIST) |
| NPI Enumeration Date | 04/15/2020 |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 24 | $0.00 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 0064A | 24 | 24 | $0.00 |