MEDICARE: VIALLON DRUG CO., INC.

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
1	183500000X	Pharmacist	7416	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093727786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIALLON DRUG CO., INC.

Provider Business Mailing Address
First Line	:	32555 BOWIE ST
Second Line	:
City	:	WHITE CASTLE
State	:	LA
Zip	:	70788-2503
Country	:	US
Telephone Number	:	225-545-2402
Fax Number	:	225-545-2903

Provider Business Practice Location Address
First Line	:	32555 BOWIE ST
Second Line	:
City	:	WHITE CASTLE
State	:	LA
Zip	:	70788-2503
Country	:	US
Telephone Number	:	225-545-2402
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PAUL LOUIS VIALLON V
Credential	:	RPH
Telephone Number	:	225-545-2402

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	02/10/2017

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Directions to “VIALLON DRUG CO., INC. ” Practice Location

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