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General NPI Number Information
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NPI Number | 1083923148
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Entity Type | Individual
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Provider Name | ROBIN RASHAUN VIDAL PHARM D
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Gender | Female
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Dates
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Enumeration Date | 10/06/2010
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 19640 HIGHWAY 67
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City | BILOXI
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State | MS
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Zip | 39532-8666
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Country | US
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Telephone | 228-702-1856
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Fax |
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Provider Business Mailing Address
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Address Line | 4642 OWENS BLVD
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City | NEW ORLEANS
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State | LA
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Zip | 70122-1225
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Country | US
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Telephone | 504-250-2679
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 18051
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 10626
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License Number State | MS
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