Provider Demographics
NPI:1790553014
Name:AIRLINE DRUG LLC
Entity Type:Organization
Organization Name:AIRLINE DRUG LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:DUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-965-6211
Mailing Address - Street 1:4660 PALMETTO RD STE D
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:LA
Mailing Address - Zip Code:71006-9742
Mailing Address - Country:US
Mailing Address - Phone:318-965-6211
Mailing Address - Fax:866-291-1577
Practice Address - Street 1:4660 PALMETTO RD STE D
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:LA
Practice Address - Zip Code:71006-9742
Practice Address - Country:US
Practice Address - Phone:318-965-6211
Practice Address - Fax:866-291-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy