Provider Demographics
NPI:1437568615
Name:VILLEJOIN, FARREL JOHN (RPH)
Entity Type:Individual
Prefix:MR
First Name:FARREL
Middle Name:JOHN
Last Name:VILLEJOIN
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 1:1002 N PARKERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-3613
Mailing Address - Country:US
Mailing Address - Phone:337-783-7200
Mailing Address - Fax:337-788-0170
Practice Address - Street 1:1002 N PARKERSON AVE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-3613
Practice Address - Country:US
Practice Address - Phone:337-783-7200
Practice Address - Fax:337-788-0170
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPST.011459OtherPHARMACY LICENSE