Provider Demographics
NPI:1497120521
Name:VUCHANSU, JOHN (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:VUCHANSU
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 MARCHAND DR
Mailing Address - Street 2:
Mailing Address - City:DONALDSONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70346-1368
Mailing Address - Country:US
Mailing Address - Phone:262-473-9368
Mailing Address - Fax:
Practice Address - Street 1:1125 MARCHAND DR
Practice Address - Street 2:
Practice Address - City:DONALDSONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70346-1368
Practice Address - Country:US
Practice Address - Phone:225-753-1499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA021382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist