Provider Demographics
NPI:1003121047
Name:MANUEL, AMANDA CATHERINE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:CATHERINE
Last Name:MANUEL
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6515 SULLIVAN RD
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-3110
Mailing Address - Country:US
Mailing Address - Phone:225-261-5497
Mailing Address - Fax:226-261-5907
Practice Address - Street 1:6515 SULLIVAN RD
Practice Address - Street 2:
Practice Address - City:GREENWELL SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70739-3110
Practice Address - Country:US
Practice Address - Phone:225-261-5497
Practice Address - Fax:226-261-5907
Is Sole Proprietor?:No
Enumeration Date:2010-08-14
Last Update Date:2010-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018917183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist