Healthcare Provider Details

I. General information

NPI: 1225283286
Provider Name (Legal Business Name): DENNIS PAUL BLANCHARD II RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52579 HIGHWAY 51 S
INDEPENDENCE LA
70443-2231
US

IV. Provider business mailing address

52579 HIGHWAY 51 S
INDEPENDENCE LA
70443-2231
US

V. Phone/Fax

Practice location:
  • Phone: 985-878-9421
  • Fax:
Mailing address:
  • Phone: 985-878-9421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number14894
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: