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NPI Code Detail

MEDICARE: PERRET ODETTE RIVERS RPH

MEDICARE: PERRET ODETTE RIVERS 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
1183500000XPharmacist14853LA

General Provider Information

NPI Number : 1528404027
Entity Type Code : Individual
Provider Name (Legal Business Name) : PERRET ODETTE RIVERS RPH
Provider Business Mailing Address
First Line : 1301 HIGHWAY 90 E
Second Line :
City : MORGAN CITY
State : LA
Zip : 70380-5158
Country : US
Telephone Number : 985-395-6181
Fax Number :
Provider Business Practice Location Address
First Line : 1301 HIGHWAY 90 E
Second Line :
City : MORGAN CITY
State : LA
Zip : 70380-5158
Country : US
Telephone Number : 985-395-6181
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2013
Last Update Date : 05/11/2013

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Directions to “ PERRET ODETTE RIVERS RPH” Practice Location

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