Willow Bark Pharmacy

LBN: Willow Mina
Willow Bark Pharmacy is an health care organization with primary practice located at 606 Highway 20 , Thibodaux LA 70301-6255. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Willow Mina can be contacted via phone (985) 633-2275, or through Nguyen, Minh via phone (985) 772-4088.

Contact Information

Primary practice address
606 Highway 20 Thibodaux LA 70301-6255
Phone: (985) 633-2275
Fax: (985) 633-4703
Website:
Map and Directions
Authorized official contact:
Name: Nguyen, Minh
Phone: (985) 772-4088

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X PHY.007400-IR Louisiana

Profile Details

NPI number 1235689977
LBN Legal business name Willow Mina
DBA Doing business as Willow Bark Pharmacy
Authorized official Nguyen, Minh
Entity Organization
Organization subpart 1 No
Enumeration date Oct 5th, 2016
Last updated Feb 14th, 2017 - about 8 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 1235689977 NPPES
Other 2166319 PK
MEDICAID 2204882 PK

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