Provider Demographics
NPI:1700285640
Name:WARR, ANGELLE J (PHARM D)
Entity Type:Individual
Prefix:
First Name:ANGELLE
Middle Name:J
Last Name:WARR
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:ANGELLE
Other - Middle Name:N
Other - Last Name:JOUBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1538 HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-2942
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1538 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-2942
Practice Address - Country:US
Practice Address - Phone:337-457-1540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-16
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.018036183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2546244Medicaid