=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720314255
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCIS P PRATTINI JR. RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/17/2009
-----------------------------------------------------
Last Update Date | 07/09/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 319 MEMPHIS ST
-----------------------------------------------------
City | BOGALUSA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70427-3845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-735-9029
-----------------------------------------------------
Fax | 985-735-9489
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3218 RANGE CT
-----------------------------------------------------
City | MANDEVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70448-8494
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-377-9597
-----------------------------------------------------
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 | 15653
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | T-010329
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------