Healthcare Provider Details

I. General information

NPI: 1275290751
Provider Name (Legal Business Name): ASIA PREJEAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SAINT NAZAIRE RD
BROUSSARD LA
70518-4202
US

IV. Provider business mailing address

101 CANE HILL DR
BROUSSARD LA
70518-7459
US

V. Phone/Fax

Practice location:
  • Phone: 337-837-1640
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.024742
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: