Provider Demographics
NPI:1285034504
Name:SASSONE, HELEN (RPH)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:SASSONE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17585 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-3303
Mailing Address - Country:US
Mailing Address - Phone:225-677-7390
Mailing Address - Fax:225-677-7388
Practice Address - Street 1:17585 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-3303
Practice Address - Country:US
Practice Address - Phone:225-677-7390
Practice Address - Fax:225-677-7388
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15708183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist