Provider Demographics
NPI:1639490394
Name:LABABIT, FELY D (RPH)
Entity Type:Individual
Prefix:MRS
First Name:FELY
Middle Name:D
Last Name:LABABIT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:FELY
Other - Middle Name:DE VERA
Other - Last Name:LABABIT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:69260 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92241-8241
Mailing Address - Country:US
Mailing Address - Phone:760-668-4188
Mailing Address - Fax:760-251-1567
Practice Address - Street 1:12900 PALM DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-4567
Practice Address - Country:US
Practice Address - Phone:760-251-3866
Practice Address - Fax:760-251-1567
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH 35047183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist