Provider Demographics
NPI:1093055436
Name:MADAFFARI, DANA SCHMITT (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:SCHMITT
Last Name:MADAFFARI
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 1:17457 LAUREN DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4667
Mailing Address - Country:US
Mailing Address - Phone:225-673-9940
Mailing Address - Fax:225-673-9940
Practice Address - Street 1:2001 MILLERVILLE RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-1408
Practice Address - Country:US
Practice Address - Phone:225-275-2109
Practice Address - Fax:225-275-2109
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018806183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist