Complete Vital Care, INC.
Pharmacy, Mail Order Pharmacy in Shreveport, LA. Organization (NPI-2).
NPI number1790799591
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1790799591
- Entity type
- Organization (NPI-2)
- Legal business name
- Complete Vital Care, INC.
- Organization subpart
- No
- Enumeration date
- Jul 28, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336M0002X | Pharmacy, Mail Order Pharmacy | 4863 IR | LA | Yes |
Other names
- Complete Vital Care - Shreveport (Doing Business As)
Practice location
2530 Bert Kouns Industrial LoopSte 116
Shreveport, LA 71118-3132
Phone 318-686-9995 · Fax 318-686-9997
Mailing address
Po Box 5047Meridian, MS 39302-5047
Phone 800-447-4095 · Fax 601-482-7490
Authorized official
George Gardiner
President
3186869995
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