Provider Demographics
NPI:1942368931
Name:MANUEL, SYLVAN J JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:SYLVAN
Middle Name:J
Last Name:MANUEL
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:547 RUE DAUPHINE
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-6536
Mailing Address - Country:US
Mailing Address - Phone:337-546-6736
Mailing Address - Fax:337-546-6736
Practice Address - Street 1:1800 W LAUREL AVE
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-2902
Practice Address - Country:US
Practice Address - Phone:337-457-4827
Practice Address - Fax:337-457-4223
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12031183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist