=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275024226
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AARON ALEXANDER HEAD PHARMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2018
-----------------------------------------------------
Last Update Date | 06/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 128 CURRAN LN
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70506-7222
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-262-9758
-----------------------------------------------------
Fax | 855-724-6797
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 307 CANDLELIGHT DR
-----------------------------------------------------
City | LAFAYETTE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70506-6658
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-532-3255
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PST.022455
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PD14175
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------