Provider Demographics
NPI:1104834738
Name:ROBICHAUX, RONALD J (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:J
Last Name:ROBICHAUX
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 1:616 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-2735
Mailing Address - Country:US
Mailing Address - Phone:985-562-9140
Mailing Address - Fax:985-532-9205
Practice Address - Street 1:616 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:LA
Practice Address - Zip Code:70374-2735
Practice Address - Country:US
Practice Address - Phone:985-562-9140
Practice Address - Fax:985-532-9205
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist