Healthcare Provider Details

I. General information

NPI: 1841570959
Provider Name (Legal Business Name): ROBERT BRIAN NEAL RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2011
Last Update Date: 08/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5696 HIGHWAY 1 BYP
NATCHITOCHES LA
71457-3254
US

IV. Provider business mailing address

5696 HIGHWAY 1 BYP
NATCHITOCHES LA
71457-3254
US

V. Phone/Fax

Practice location:
  • Phone: 318-214-0048
  • Fax: 318-214-0790
Mailing address:
  • Phone: 318-214-0048
  • Fax: 318-214-0790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number16666
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: