NPI 1144734153

Northshore Interventional Pain Management

Organisation Non-Pharmacy Dispensing Site Covington, LA

Practice location

Address: 7015 Hwy 190 E Service Rd. STE 101, Covington, LA 70433
Phone: (479) 636-9702
Fax: (877) 427-2307
Mailing address: PO Box 3328, Bentonville, AR 72712

Authorised official

Name: Mackenzie Hahn
Title: Ncpdp Coordinator
Phone: (479) 636-9702

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X Licence MD.020506 (LA)

Other Non-Pharmacy Dispensing Site providers in Louisiana →

Registry record

NPI: 1144734153
Entity type: Organization
NPI issued: 29 Nov 2017
Record last updated: 29 Nov 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.