Healthcare Provider Details

I. General information

NPI: 1376120055
Provider Name (Legal Business Name): MARKUS SANTAMARIA PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2021
Last Update Date: 03/27/2021
Certification Date: 03/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 HIGHWAY 165 S
OAKDALE LA
71463-5098
US

IV. Provider business mailing address

512 HARMONY DR
OAKDALE LA
71463-2314
US

V. Phone/Fax

Practice location:
  • Phone: 318-335-3131
  • Fax:
Mailing address:
  • Phone: 318-335-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.023819
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: