NPI 1568510030
Ideal Health Mart Pharmacy INC
Practice location
- Address
- 610 N Pine St, Deridder, LA 70634-3546
- Phone
- (337) 463-7210
- Fax
- (337) 462-0930
Authorised official
- Name
- Kesa Lane
- Title
- Rph/Owner
- Phone
- (337) 463-7210
Registered specialties
Pharmacy
Primary
Registry record
- NPI
- 1568510030
- Entity type
- Organization
- NPI issued
- 8 Jan 2007
- Record last updated
- 16 May 2014
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.