Provider Demographics
NPI:1750980942
Name:ASHWORTH, TAYLOR L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:L
Last Name:ASHWORTH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N BOONE ST
Mailing Address - Street 2:
Mailing Address - City:DEQUINCY
Mailing Address - State:LA
Mailing Address - Zip Code:70633-3008
Mailing Address - Country:US
Mailing Address - Phone:337-853-5390
Mailing Address - Fax:
Practice Address - Street 1:6225 COLISEUM BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3980
Practice Address - Country:US
Practice Address - Phone:318-448-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST023685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist