Provider Demographics
NPI:1376792341
Name:ALLAIN, PHILOMENE BURRELL
Entity Type:Individual
Prefix:MS
First Name:PHILOMENE
Middle Name:BURRELL
Last Name:ALLAIN
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 1:3732 SILVER MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70131-8326
Mailing Address - Country:US
Mailing Address - Phone:504-430-8790
Mailing Address - Fax:504-899-2613
Practice Address - Street 1:3732 SILVER MAPLE CT
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-8326
Practice Address - Country:US
Practice Address - Phone:504-430-8790
Practice Address - Fax:504-899-2613
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290627183500000X
LA145911835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist