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NPI Code Detail

MEDICARE: NANCY ODOM RPH

MEDICARE: NANCY ODOM RPH
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
1183500000XPharmacist14796LA

General Provider Information

NPI Number : 1306443932
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY ODOM RPH
Provider Business Mailing Address
First Line : 113 SOHO CIR
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-4237
Country : US
Telephone Number : 337-303-6103
Fax Number :
Provider Business Practice Location Address
First Line : 505 BERTRAND DR
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-5542
Country : US
Telephone Number : 337-893-9274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2020
Last Update Date : 07/25/2023

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Directions to “ NANCY ODOM RPH” Practice Location

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