Healthcare Provider Details

I. General information

NPI: 1881625101
Provider Name (Legal Business Name): RAMI G. BRIGNAC R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 MARTIN STREET
PARKS LA
70582
US

IV. Provider business mailing address

110 STEVE ST
LAFAYETTE LA
70503-6048
US

V. Phone/Fax

Practice location:
  • Phone: 337-845-5199
  • Fax: 337-845-5070
Mailing address:
  • Phone: 337-981-8870
  • Fax: 337-845-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13799
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: