Healthcare Provider Details

I. General information

NPI: 1093545311
Provider Name (Legal Business Name): RYLEE MARIE SCHULTZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2024
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2915 HIGHWAY 190
MANDEVILLE LA
70471-3298
US

IV. Provider business mailing address

30201 PHILIP SMITH RD
LACOMBE LA
70445-3339
US

V. Phone/Fax

Practice location:
  • Phone: 985-626-8106
  • Fax:
Mailing address:
  • Phone: 985-788-7545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025414
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: