MEDICARE: MR. DARRYL GIRARD SHILOH RPH

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
1	183500000X	Pharmacist	14871	LA

General Provider Information

NPI Number	:	1730263344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DARRYL GIRARD SHILOH RPH

Provider Business Mailing Address
First Line	:	1603 LICHESTER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810
Country	:	US
Telephone Number	:	225-752-5841
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 GREENWELL SPRINGS
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70805
Country	:	US
Telephone Number	:	225-216-9442
Fax Number	:	225-216-1751

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	07/08/2007

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