Provider Demographics
NPI:1346558814
Name:MENARD, NEIL (RPH)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:MENARD
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 1:1210 ALBERTSON PKWY
Mailing Address - Street 2:
Mailing Address - City:BROUSSARD
Mailing Address - State:LA
Mailing Address - Zip Code:70518-4347
Mailing Address - Country:US
Mailing Address - Phone:337-839-0530
Mailing Address - Fax:
Practice Address - Street 1:1210 ALBERTSON PKWY
Practice Address - Street 2:
Practice Address - City:BROUSSARD
Practice Address - State:LA
Practice Address - Zip Code:70518-4347
Practice Address - Country:US
Practice Address - Phone:337-839-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-18
Last Update Date:2010-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17323183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist