MEDICARE: PAMELA DUPLECHAIN-CELLUM DOCTOR OF PHARMACY

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	16234	LA

General Provider Information

NPI Number	:	1831404870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA DUPLECHAIN-CELLUM DOCTOR OF PHARMACY

Provider Business Mailing Address
First Line	:	1106 N MARTIN LUTHER KING HWY
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-2048
Country	:	US
Telephone Number	:	337-436-7833
Fax Number	:	337-436-1119

Provider Business Practice Location Address
First Line	:	1106 N MARTIN LUTHER KING HWY
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-2048
Country	:	US
Telephone Number	:	337-436-7833
Fax Number	:	337-436-1119

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

Provider Enumeration Date	:	08/14/2010
Last Update Date	:	08/14/2010

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