MEDICARE: MRS. TARA SPAULDING COMEAUX 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
1	183500000X	Pharmacist	16843	LA

General Provider Information

NPI Number	:	1659707784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TARA SPAULDING COMEAUX RPH

Provider Business Mailing Address
First Line	:	1100 VETERANS MEMORIAL DR
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-3128
Country	:	US
Telephone Number	:	337-893-0592
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 VETERANS MEMORIAL DR
Second Line	:
City	:	ABBEVILLE
State	:	LA
Zip	:	70510-3128
Country	:	US
Telephone Number	:	337-893-0592
Fax Number	:

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

Provider Enumeration Date	:	09/20/2013
Last Update Date	:	09/20/2013

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