Provider Demographics
NPI:1508141201
Name:LOUIE, RAYMOND (BS)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:LOUIE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MOUNT HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4100
Mailing Address - Country:US
Mailing Address - Phone:609-386-5736
Mailing Address - Fax:
Practice Address - Street 1:2200 MOUNT HOLLY RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-4100
Practice Address - Country:US
Practice Address - Phone:609-386-5736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02883800183500000X
AZS12628183500000X
PARP438108183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist