Provider Demographics
NPI:1689896508
Name:RAYMOND, JANET A (RPH)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:A
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 COURTHOUSE LANE
Mailing Address - Street 2:
Mailing Address - City:HAHNVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70057
Mailing Address - Country:US
Mailing Address - Phone:504-348-8212
Mailing Address - Fax:
Practice Address - Street 1:5969 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072
Practice Address - Country:US
Practice Address - Phone:504-340-2078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist