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NPI Code Detail

MEDICARE: MS. SHIONKA S PATTERSON PHARM. D.

MEDICARE: MS. SHIONKA S PATTERSON PHARM. D.
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
1183500000XPharmacist019963LA
2183500000XPharmacistMA 1968LA

General Provider Information

NPI Number : 1891031142
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHIONKA S PATTERSON PHARM. D.
Provider Business Mailing Address
First Line : 120 N HIGHWAY 171
Second Line :
City : MOSS BLUFF
State : LA
Zip : 70611-5343
Country : US
Telephone Number : 337-855-4848
Fax Number : 337-855-8631
Provider Business Practice Location Address
First Line : 120 N HIGHWAY 171
Second Line :
City : MOSS BLUFF
State : LA
Zip : 70611-5343
Country : US
Telephone Number : 337-855-4848
Fax Number : 337-855-8631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2012
Last Update Date : 12/13/2012

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