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NPI Code Detail

MEDICARE: NATALIE MECKLENBORG PHARM D

MEDICARE: NATALIE MECKLENBORG PHARM D
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
1183500000XPharmacist17117LA

General Provider Information

NPI Number : 1740595834
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE MECKLENBORG PHARM D
Provider Business Mailing Address
First Line : 2880 HIGHWAY 190
Second Line :
City : MANDEVILLE
State : LA
Zip : 70471-3254
Country : US
Telephone Number : 985-624-8548
Fax Number : 985-624-4872
Provider Business Practice Location Address
First Line : 2880 HIGHWAY 190
Second Line :
City : MANDEVILLE
State : LA
Zip : 70471-3254
Country : US
Telephone Number : 985-624-8548
Fax Number : 985-624-4872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2010
Last Update Date : 08/12/2010

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