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NPI Code Detail

MEDICARE: MR. PATRICK LEO MILLS JR. R.PH.

MEDICARE: MR. PATRICK LEO MILLS JR. R.PH.
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
1183500000XPharmacist16715LA

General Provider Information

NPI Number : 1982039434
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK LEO MILLS JR. R.PH.
Provider Business Mailing Address
First Line : 9155 MANSFIELD RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71118
Country : US
Telephone Number : 318-688-2582
Fax Number : 318-671-8359
Provider Business Practice Location Address
First Line : 9155 MANSFIELD RD
Second Line :
City : SHREVEPORT
State : LA
Zip : 71118-3122
Country : US
Telephone Number : 318-688-2582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2013
Last Update Date : 09/03/2013

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