Provider Demographics
NPI:1821497850
Name:ORGERON, AMI
Entity Type:Individual
Prefix:
First Name:AMI
Middle Name:
Last Name:ORGERON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16759 HIGHWAY 3235
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-4053
Mailing Address - Country:US
Mailing Address - Phone:985-632-4727
Mailing Address - Fax:
Practice Address - Street 1:16759 HIGHWAY 3235
Practice Address - Street 2:
Practice Address - City:CUT OFF
Practice Address - State:LA
Practice Address - Zip Code:70345-4053
Practice Address - Country:US
Practice Address - Phone:985-632-4727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.015753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist