Healthcare Provider Details

I. General information

NPI: 1205194446
Provider Name (Legal Business Name): MARCIE JILL CAUSEY PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 S AIRLINE HWY
GONZALES LA
70737-3633
US

IV. Provider business mailing address

115 S AIRLINE HWY
GONZALES LA
70737-3633
US

V. Phone/Fax

Practice location:
  • Phone: 225-647-7980
  • Fax: 225-647-8369
Mailing address:
  • Phone: 225-647-7980
  • Fax: 225-647-8369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17744
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: