Provider Demographics
NPI:1386679041
Name:ST. LOUIS, JUDITH HARLYN (R PH)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:HARLYN
Last Name:ST. LOUIS
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5384 N PALM AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2207
Mailing Address - Country:US
Mailing Address - Phone:559-439-4560
Mailing Address - Fax:559-266-1012
Practice Address - Street 1:4160 E CLINTON AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93703-2520
Practice Address - Country:US
Practice Address - Phone:559-266-0601
Practice Address - Fax:559-266-1012
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH24334183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist