Provider Demographics
NPI:1073515722
Name:AUCOIN, PHILIP C (RPH)
Entity Type:Individual
Prefix:MR
First Name:PHILIP
Middle Name:C
Last Name:AUCOIN
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 1:1815 SQUIRREL RUN
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-1458
Mailing Address - Country:US
Mailing Address - Phone:337-365-5381
Mailing Address - Fax:337-365-0771
Practice Address - Street 1:1104 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560
Practice Address - Country:US
Practice Address - Phone:337-365-8048
Practice Address - Fax:337-365-5350
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist