Provider Demographics
NPI:1053076067
Name:CALLAHAN, RHANDA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RHANDA
Middle Name:
Last Name:CALLAHAN
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 1:3031 MECHE LN
Mailing Address - Street 2:
Mailing Address - City:PORT ALLEN
Mailing Address - State:LA
Mailing Address - Zip Code:70767-4027
Mailing Address - Country:US
Mailing Address - Phone:504-919-2829
Mailing Address - Fax:
Practice Address - Street 1:3031 MECHE LN
Practice Address - Street 2:
Practice Address - City:PORT ALLEN
Practice Address - State:LA
Practice Address - Zip Code:70767-4027
Practice Address - Country:US
Practice Address - Phone:504-919-2829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPHA.0021576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPHA.0021576OtherPHARMACIST LICENSE
LAPST.021354OtherPHARMACIST LICENSE