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NPI Code Detail

MEDICARE: MARY MARGARET WHITE DOWNHOUR

MEDICARE: MARY MARGARET WHITE DOWNHOUR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPST.022331LA

General Provider Information

NPI Number : 1063913960
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MARGARET WHITE DOWNHOUR
Provider Business Mailing Address
First Line : 1247 SWARTZ FAIRBANKS RD
Second Line :
City : MONROE
State : LA
Zip : 71203-9705
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2400 CYPRESS ST
Second Line :
City : WEST MONROE
State : LA
Zip : 71291-4555
Country : US
Telephone Number : 318-267-3001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2018
Last Update Date : 02/26/2018

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Directions to “ MARY MARGARET WHITE DOWNHOUR ” Practice Location

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