Provider Demographics
NPI:1356689889
Name:LEJEUNE, ANDRE LANIER (RPH)
Entity type:Individual
Prefix:
First Name:ANDRE
Middle Name:LANIER
Last Name:LEJEUNE
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 1:1720 NICHOLSON DR
Mailing Address - Street 2:UNIT 25
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70802-8133
Mailing Address - Country:US
Mailing Address - Phone:225-810-3303
Mailing Address - Fax:
Practice Address - Street 1:3550 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-5718
Practice Address - Country:US
Practice Address - Phone:225-343-8878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15276183500000X
CARPH45141183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist