Provider Demographics
NPI:1013417583
Name:LANDRY, VALERIE D (PHARMD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:D
Last Name:LANDRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1620 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-4310
Mailing Address - Country:US
Mailing Address - Phone:337-394-9772
Mailing Address - Fax:337-394-9773
Practice Address - Street 1:1620 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-4310
Practice Address - Country:US
Practice Address - Phone:337-394-9772
Practice Address - Fax:337-394-9773
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist