Healthcare Provider Details

I. General information

NPI: 1376468645
Provider Name (Legal Business Name): AMANDA MCDUFFIE PHILIBERT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29148 S MONTPELIER RD
ALBANY LA
70711-4320
US

IV. Provider business mailing address

42466 HAMILTON LN
PONCHATOULA LA
70454-4244
US

V. Phone/Fax

Practice location:
  • Phone: 225-209-6003
  • Fax:
Mailing address:
  • Phone: 985-630-4787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.023148
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: