MEDICARE: DONALD B OLIVIER

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	9124	LA

General Provider Information

NPI Number	:	1174807796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONALD B OLIVIER

Provider Business Mailing Address
First Line	:	6502 HWY 182 EAST
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380
Country	:	US
Telephone Number	:	985-384-2126
Fax Number	:	985-384-2120

Provider Business Practice Location Address
First Line	:	6502 HIGHWAY 182 E
Second Line	:
City	:	MORGAN CITY
State	:	LA
Zip	:	70380-2034
Country	:	US
Telephone Number	:	985-384-2126
Fax Number	:	985-384-2120

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	09/30/2011

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