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NPI Code Detail

MEDICARE: FREDDY STRATTON PHARMACIST

MEDICARE:   FREDDY  STRATTON  PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist9793LA

General Provider Information

NPI Number : 1629477765
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDDY STRATTON PHARMACIST
Provider Business Mailing Address
First Line : 2204 S 5TH ST
Second Line :
City : LEESVILLE
State : LA
Zip : 71446-5318
Country : US
Telephone Number : 337-238-9305
Fax Number : 337-238-9323
Provider Business Practice Location Address
First Line : 2204 S 5TH ST
Second Line :
City : LEESVILLE
State : LA
Zip : 71446-5318
Country : US
Telephone Number : 337-238-9305
Fax Number : 337-238-9323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2014
Last Update Date : 08/14/2014

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Directions to “ FREDDY STRATTON PHARMACIST” Practice Location

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