Provider Demographics
NPI:1568797850
Name:AUGUSTUS, MARVENE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:MARVENE
Middle Name:
Last Name:AUGUSTUS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9807 VOUVRAY DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-7646
Mailing Address - Country:US
Mailing Address - Phone:225-753-7140
Mailing Address - Fax:225-358-4992
Practice Address - Street 1:9807 VOUVRAY DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70817-7646
Practice Address - Country:US
Practice Address - Phone:225-753-7140
Practice Address - Fax:225-358-4992
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112011835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist