Provider Demographics
NPI:1265652630
Name:MORGAN, ROSHEBA SHANEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROSHEBA
Middle Name:SHANEE
Last Name:MORGAN
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 1:3933 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-5835
Mailing Address - Country:US
Mailing Address - Phone:504-365-1252
Mailing Address - Fax:
Practice Address - Street 1:5969 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4833
Practice Address - Country:US
Practice Address - Phone:504-340-7984
Practice Address - Fax:504-340-2078
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist