Provider Demographics
NPI:1609927904
Name:LABENNE, LAWRENCE LEON (PHARM-D, RPH)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:LEON
Last Name:LABENNE
Suffix:
Gender:M
Credentials:PHARM-D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1888
Mailing Address - Country:US
Mailing Address - Phone:814-371-9000
Mailing Address - Fax:
Practice Address - Street 1:100 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1888
Practice Address - Country:US
Practice Address - Phone:814-371-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP441567183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist