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General NPI Number Information
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NPI Number | 1578110789
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Entity Type | Individual
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Provider Name | RENEISHA ARMONII ROBERTS RPH
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Gender | Female
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Dates
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Enumeration Date | 08/22/2019
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 3100 LA-28
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City | PINEVILLE
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State | LA
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Zip | 71360
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Country | US
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Telephone | 318-561-2381
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9113
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City | NEW IBERIA
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State | LA
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Zip | 70562-9113
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Country | US
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Telephone | 337-256-0268
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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 | PST.023144
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License Number State | LA
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