Healthcare Provider Details

I. General information

NPI: 1710976063
Provider Name (Legal Business Name): CHARLES S. FEUCHT PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 10/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 N SECOND ST
EUNICE LA
70535-3342
US

IV. Provider business mailing address

PO BOX 1288 440 N 2ND
EUNICE LA
70535-1288
US

V. Phone/Fax

Practice location:
  • Phone: 337-457-4604
  • Fax: 337-546-0900
Mailing address:
  • Phone: 337-457-4604
  • Fax: 337-546-0900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number11038
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: