Provider Demographics
NPI:1669936407
Name:SAVOIE, LYLA WHAM
Entity type:Individual
Prefix:
First Name:LYLA
Middle Name:WHAM
Last Name:SAVOIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 MORNINGSIDE DR
Mailing Address - Street 2:
Mailing Address - City:DUSON
Mailing Address - State:LA
Mailing Address - Zip Code:70529-3928
Mailing Address - Country:US
Mailing Address - Phone:337-278-7152
Mailing Address - Fax:337-233-3385
Practice Address - Street 1:5900 CAMERON STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583
Practice Address - Country:US
Practice Address - Phone:337-233-3382
Practice Address - Fax:337-233-3385
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.016766183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAMA.004517OtherLOUISIANA BOARD OF PHARMACY MEDICATION ADMINISTRATION LICENSE NUMBER
LAPST.016766OtherLOUISIANA BOARD OF PHARMACY LICENSE NUMBER