Healthcare Provider Details

I. General information

NPI: 1548660855
Provider Name (Legal Business Name): JUOWEN HUANG PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 03/15/2023
Certification Date: 03/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2495 SHREVEPORT HWY
PINEVILLE LA
71360-4044
US

IV. Provider business mailing address

2495 SHREVEPORT HWY
PINEVILLE LA
71360-4044
US

V. Phone/Fax

Practice location:
  • Phone: 318-473-0010
  • Fax: 318-483-5013
Mailing address:
  • Phone: 318-473-0010
  • Fax: 318-483-5013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.020718
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: