Provider Demographics
NPI:1396375184
Name:HEROUX-CAMIRAND, LAUREN ADELLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ADELLE
Last Name:HEROUX-CAMIRAND
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ADELRAY LN
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-4674
Mailing Address - Country:US
Mailing Address - Phone:401-556-4108
Mailing Address - Fax:
Practice Address - Street 1:23 ADELRAY LN
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-4674
Practice Address - Country:US
Practice Address - Phone:401-556-4108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26611183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist