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NPI Code Detail

MEDICARE: STEPHANIE LAND R.PH.

MEDICARE: STEPHANIE LAND R.PH.
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
1183500000XPharmacist16797LA

General Provider Information

NPI Number : 1447379201
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LAND R.PH.
Provider Business Mailing Address
First Line : 517 BOB ODOM LOOP
Second Line :
City : WOODWORTH
State : LA
Zip : 71485-4808
Country : US
Telephone Number : 318-487-0342
Fax Number : 318-448-1328
Provider Business Practice Location Address
First Line : 517 BOB ODOM LOOP
Second Line :
City : WOODWORTH
State : LA
Zip : 71485-4808
Country : US
Telephone Number : 318-487-0342
Fax Number : 318-448-1328
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2007
Last Update Date : 08/27/2013

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Directions to “ STEPHANIE LAND R.PH.” Practice Location

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