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General NPI Number Information
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NPI Number | 1639770811
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Entity Type | Individual
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Provider Name | LAURA DROUIN
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 1511 CAMP JACKSON RD
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City | CAHOKIA
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State | IL
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Zip | 62206-2537
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Country | US
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Telephone | 618-332-1133
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Fax | 618-332-1134
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Provider Business Mailing Address
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Address Line | 1330 BOSSLER LN
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City | O FALLON
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State | IL
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Zip | 62269-7128
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Country | US
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Telephone | 618-593-5772
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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 | 051037108
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License Number State | IL
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