Provider Demographics
NPI:1851606800
Name:LOUP, AMBER M (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:M
Last Name:LOUP
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4747 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4638
Mailing Address - Country:US
Mailing Address - Phone:225-302-7242
Mailing Address - Fax:
Practice Address - Street 1:4747 S SHERWOOD FOREST BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4638
Practice Address - Country:US
Practice Address - Phone:225-292-8975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-15
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist