Provider Demographics
NPI:1083944136
Name:ORLANDO, BEN BERNARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:BERNARD
Last Name:ORLANDO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:BEN
Other - Middle Name:BERNARD
Other - Last Name:ORLANDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:1815 N 18TH ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-4401
Mailing Address - Country:US
Mailing Address - Phone:318-322-3141
Mailing Address - Fax:318-361-9618
Practice Address - Street 1:1815 N 18TH ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-4401
Practice Address - Country:US
Practice Address - Phone:318-322-3141
Practice Address - Fax:318-361-9618
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist