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Pharmacy Service Providers Pharmacist Pharmacotherapy

Provider NPI: 1609975648

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
Tel: 504-842-6124  Fax: --

Business Mailing Address:
496 HAMILTON ST  GRETNA, LA 70053-4710 US
Tel: 504-361-7532  Fax: --

NPI Information:
NPI: 1609975648
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y1835P1200XPharmacy Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 1835P1200X





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