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NPI Code Detail

MEDICARE: MRS. LINDA SYLVIA REYNOLDS R. PH.

MEDICARE: MRS. LINDA SYLVIA REYNOLDS 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
1183500000XPharmacist11745LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111745OTHERLALOUISIANA STATE BOARD OF PHARMACY

General Provider Information

NPI Number : 1780018929
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDA SYLVIA REYNOLDS R. PH.
Provider Business Mailing Address
First Line : 1422 MACARTHUR DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-4022
Country : US
Telephone Number : 318-442-0512
Fax Number :
Provider Business Practice Location Address
First Line : 1422 MACARTHUR DR
Second Line :
City : ALEXANDRIA
State : LA
Zip : 71301-4022
Country : US
Telephone Number : 318-442-0512
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2013
Last Update Date : 08/23/2013

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