Healthcare Provider Details

I. General information

NPI: 1700206265
Provider Name (Legal Business Name): JAMES SCOTT VALLEE R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: J. SCOTT VALLEE R.PH.

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 04/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2803 HIGHWAY 59
MANDEVILLE LA
70471-1936
US

IV. Provider business mailing address

2803 HIGHWAY 59
MANDEVILLE LA
70471-1936
US

V. Phone/Fax

Practice location:
  • Phone: 985-626-0234
  • Fax: 985-626-0227
Mailing address:
  • Phone: 985-626-0234
  • Fax: 985-626-0227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15543
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: