Healthcare Provider Details

I. General information

NPI: 1467082974
Provider Name (Legal Business Name): THO LE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11485 FLORIDA BLVD STE B
BATON ROUGE LA
70815-2404
US

IV. Provider business mailing address

11485 FLORIDA BLVD STE B
BATON ROUGE LA
70815-2404
US

V. Phone/Fax

Practice location:
  • Phone: 225-465-4251
  • Fax:
Mailing address:
  • Phone: 225-465-4251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.024475
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: