Provider Demographics
NPI:1356924864
Name:ROBICHAUX, KEVIN PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:PAUL
Last Name:ROBICHAUX
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 1:180 WINDERMERE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3535
Mailing Address - Country:US
Mailing Address - Phone:318-445-8770
Mailing Address - Fax:318-445-8979
Practice Address - Street 1:180 WINDERMERE BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3535
Practice Address - Country:US
Practice Address - Phone:318-445-8770
Practice Address - Fax:318-445-8979
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.015223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPST.015223OtherLOUISIANA BOARD OF PHARMACY