OrganizationActive
Ideal Health Mart Pharmacy Inc
NPI 1568510030 · Pharmacy · Deridder, LA
Provider details
- NPI number
- 1568510030
- Entity type
- Organization
- Primary specialty
- PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kesa Lane, Rph/Owner(337) 463-7210
- License
- 006477 (LA)
Specialties & taxonomies
Suppliers
Practice location
610 N Pine St
Deridder, LA 70634-3546
Phone: (337) 463-7210
Fax: (337) 462-0930
Approximate (ZIP-level) locationGet directions
Mailing address
610 N Pine St
Deridder, LA 70634-3546
Other names (DBA / former)
- Doing business as
- Ideal Health Mart
Registry dates
- Enumerated
- 2007-01-08
- Last updated
- 2014-05-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.