Provider Demographics
NPI:1639916331
Name:SLAVICH, JOSEPH MICHAEL (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:MICHAEL
Last Name:SLAVICH
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30319 HIGHWAY 23
Mailing Address - Street 2:
Mailing Address - City:BURAS
Mailing Address - State:LA
Mailing Address - Zip Code:70041-2622
Mailing Address - Country:US
Mailing Address - Phone:504-401-1228
Mailing Address - Fax:
Practice Address - Street 1:436 LAPALCO BLVD
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7335
Practice Address - Country:US
Practice Address - Phone:504-393-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA025298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist