Provider Demographics
NPI:1558690925
Name:BIGLANE, JOHN GABRIEL (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GABRIEL
Last Name:BIGLANE
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 1:502 GRAMMONT ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-7515
Mailing Address - Country:US
Mailing Address - Phone:318-387-7868
Mailing Address - Fax:318-324-9425
Practice Address - Street 1:502 GRAMMONT ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-7515
Practice Address - Country:US
Practice Address - Phone:318-387-7868
Practice Address - Fax:318-324-9425
Is Sole Proprietor?:No
Enumeration Date:2009-12-15
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA9745OtherPHARMACY LICENSE #