Provider Demographics
NPI:1376759340
Name:LORMAND, ROLAND J
Entity Type:Individual
Prefix:
First Name:ROLAND
Middle Name:J
Last Name:LORMAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 90253
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70509-0253
Mailing Address - Country:US
Mailing Address - Phone:337-234-3654
Mailing Address - Fax:
Practice Address - Street 1:919 NAPOLEON AVE
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6100
Practice Address - Country:US
Practice Address - Phone:337-662-5298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist