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General NPI Number Information
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NPI Number | 1770890741
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Entity Type | Individual
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Provider Name | BERNARD SALTAFORMAGGIO RPH
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Gender | Male
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Dates
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Enumeration Date | 09/10/2010
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Last Update Date | 09/10/2010
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Provider Practice Location Address
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Address Line | 34876 LA HIGHWAY 1019
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City | DENHAM SPRINGS
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State | LA
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Zip | 70706-0659
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Country | US
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Telephone | 225-667-4286
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 710
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City | WATSON
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State | LA
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Zip | 70786-0710
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Country | US
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Telephone | 225-667-4286
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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 | LA11448
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License Number State | LA
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