Provider Demographics
NPI:1770101230
Name:SEAL, AARON REID (PHARMACIST)
Entity type:Individual
Prefix:
First Name:AARON
Middle Name:REID
Last Name:SEAL
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25242 TAYLOR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-5230
Mailing Address - Country:US
Mailing Address - Phone:985-517-8430
Mailing Address - Fax:
Practice Address - Street 1:210 AVENUE G
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:LA
Practice Address - Zip Code:70444-2804
Practice Address - Country:US
Practice Address - Phone:985-229-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist