Provider Demographics
NPI:1265856058
Name:ELVIN REED & PHYLLIS VIDRINE
Entity Type:Organization
Organization Name:ELVIN REED & PHYLLIS VIDRINE
Other - Org Name:REED'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VIDRINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-468-5207
Mailing Address - Street 1:1009 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MAMOU
Mailing Address - State:LA
Mailing Address - Zip Code:70554-3123
Mailing Address - Country:US
Mailing Address - Phone:337-468-5207
Mailing Address - Fax:337-468-5932
Practice Address - Street 1:1009 6TH ST
Practice Address - Street 2:
Practice Address - City:MAMOU
Practice Address - State:LA
Practice Address - Zip Code:70554-3123
Practice Address - Country:US
Practice Address - Phone:337-468-5207
Practice Address - Fax:337-468-5932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy