Healthcare Provider Details

I. General information

NPI: 1629700885
Provider Name (Legal Business Name): CHERYL L HAQ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2022
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12506 HIGHWAY 73
GEISMAR LA
70734-3209
US

IV. Provider business mailing address

12506 HIGHWAY 73
GEISMAR LA
70734-3209
US

V. Phone/Fax

Practice location:
  • Phone: 225-677-7607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.024304
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: