Provider Demographics
NPI:1568634137
Name:EUBANKS, STEVEN (RPH)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:EUBANKS
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 1:313 PERRY LOOP
Mailing Address - Street 2:P.O. BOX 465
Mailing Address - City:POLLOCK
Mailing Address - State:LA
Mailing Address - Zip Code:71467
Mailing Address - Country:US
Mailing Address - Phone:318-765-2174
Mailing Address - Fax:
Practice Address - Street 1:211 4TH ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8421
Practice Address - Country:US
Practice Address - Phone:318-473-3067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15590183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist