Provider Demographics
NPI:1114039104
Name:SAV MOR DRUGS INC
Entity Type:Organization
Organization Name:SAV MOR DRUGS INC
Other - Org Name:SAV MOR DRUGS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EBERHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-785-2145
Mailing Address - Street 1:PO BOX 523
Mailing Address - Street 2:
Mailing Address - City:BOUTTE
Mailing Address - State:LA
Mailing Address - Zip Code:70039-0523
Mailing Address - Country:US
Mailing Address - Phone:985-785-2145
Mailing Address - Fax:985-785-0844
Practice Address - Street 1:13413 HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:BOUTTE
Practice Address - State:LA
Practice Address - Zip Code:70039-3007
Practice Address - Country:US
Practice Address - Phone:988-785-2145
Practice Address - Fax:988-785-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LA22893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1923590OtherNCPDP PROVIDER IDENTIFICATION NUMBER