Urban Drug Store Inc

LBN: Urban Drug Store Inc
Urban Drug Store Inc is an health care organization with primary practice located at 1910 Jackson St , Monroe LA 71202-2532. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Urban Drug Store Inc can be contacted via phone (318) 388-1374, or through Walters, Kermit Lamar via phone (318) 388-1374.

Contact Information

Primary practice address
1910 Jackson St Monroe LA 71202-2532
Phone: (318) 388-1374
Fax: (318) 398-0888
Website:
Map and Directions
Authorized official contact:
Name: Walters, Kermit Lamar Doctor of Medicine (MD)
Phone: (318) 388-1374

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 2328IR Louisiana

Profile Details

NPI number 1932207081
LBN Legal business name Urban Drug Store Inc
DBA Doing business as
Authorized official Walters, Kermit Lamar Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Sep 20th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932207081 NPPES
Louisiana MEDICAID 1259136
Louisiana Other 1921938
Louisiana Other 2328IR

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