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General NPI Number Information
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NPI Number | 1992326763
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Entity Type | Individual
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Provider Name | ROBIN MARK DESHOTEL RPH
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Gender | Male
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Dates
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Enumeration Date | 05/02/2020
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1508 CAJUN DR
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City | MAMOU
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State | LA
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Zip | 70554-2400
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Country | US
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Telephone | 337-468-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 27020 RUFFIN RD
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City | ELTON
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State | LA
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Zip | 70532-4300
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Country | US
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Telephone | 337-523-0530
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Fax | 337-246-3946
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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 | PIC.016723
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License Number State | LA
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