Provider Demographics
NPI:1760619407
Name:LEBLANC, DANNY M (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:M
Last Name:LEBLANC
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 1:464 SUZIE DR
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-7703
Mailing Address - Country:US
Mailing Address - Phone:337-580-9228
Mailing Address - Fax:
Practice Address - Street 1:1538 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-2942
Practice Address - Country:US
Practice Address - Phone:337-457-1540
Practice Address - Fax:337-457-1567
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-21
Last Update Date:2009-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist