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General NPI Number Information
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NPI Number | 1538237326
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Entity Type | Organization
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Legal Business Name | DONALD L ENGLERTH
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 02/18/2011
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Provider Practice Location Address
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Address Line | 7584 GILBERT ST
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City | GILBERT
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State | LA
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Zip | 71336
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Country | US
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Telephone | 318-435-5702
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Fax | 318-435-4883
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Provider Business Mailing Address
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Address Line | PO BOX 870
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City | GILBERT
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State | LA
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Zip | 71336-0870
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Country | US
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Telephone | 318-435-5702
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Fax | 318-435-1883
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Authorized Official
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Title or Position | OWNER
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Name | DONALD ENGLERTH
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Credential |
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Telephone | 318-435-5702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PHY001657IR
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License Number State | LA
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