Provider Demographics
NPI:1205315264
Name:VO, ROWENA HELEN (PST022565)
Entity type:Individual
Prefix:
First Name:ROWENA
Middle Name:HELEN
Last Name:VO
Suffix:
Gender:F
Credentials:PST022565
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 E IDLEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2933
Mailing Address - Country:US
Mailing Address - Phone:504-864-3026
Mailing Address - Fax:
Practice Address - Street 1:7411 FLORIDA BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-4639
Practice Address - Country:US
Practice Address - Phone:225-928-8982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.022565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist