Provider Demographics
NPI:1093325524
Name:DUONG, CALEB HUY (PHARMD)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:HUY
Last Name:DUONG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13242 DWYER BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70129-1317
Mailing Address - Country:US
Mailing Address - Phone:504-439-2182
Mailing Address - Fax:
Practice Address - Street 1:5416 CAMERON ST
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583-5285
Practice Address - Country:US
Practice Address - Phone:337-266-5884
Practice Address - Fax:337-266-8495
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.023528183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist