Provider Demographics
NPI:1033248851
Name:COATES, DARREN L (RPH)
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:L
Last Name:COATES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:566 MANCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4916
Mailing Address - Country:US
Mailing Address - Phone:985-781-5898
Mailing Address - Fax:
Practice Address - Street 1:2985 GAUSE BLVD E
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4154
Practice Address - Country:US
Practice Address - Phone:985-639-1561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16555183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist