Provider Demographics
NPI:1497310916
Name:GTTB LLC
Entity Type:Organization
Organization Name:GTTB LLC
Other - Org Name:J & K DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOOK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:318-719-9471
Mailing Address - Street 1:7190 HIGHWAY 165
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:LA
Mailing Address - Zip Code:71418-3302
Mailing Address - Country:US
Mailing Address - Phone:318-649-0825
Mailing Address - Fax:318-649-0507
Practice Address - Street 1:7190 HIGHWAY 165
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:LA
Practice Address - Zip Code:71418-3302
Practice Address - Country:US
Practice Address - Phone:318-649-0825
Practice Address - Fax:318-649-0507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy