Provider Demographics
NPI:1881625101
Name:BRIGNAC, RAMI G (RPH)
Entity type:Individual
Prefix:MRS
First Name:RAMI
Middle Name:G
Last Name:BRIGNAC
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 STEVE ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-6048
Mailing Address - Country:US
Mailing Address - Phone:337-981-8870
Mailing Address - Fax:337-845-5070
Practice Address - Street 1:1027 MARTIN STREET
Practice Address - Street 2:
Practice Address - City:PARKS
Practice Address - State:LA
Practice Address - Zip Code:70582
Practice Address - Country:US
Practice Address - Phone:337-845-5199
Practice Address - Fax:337-845-5070
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13799183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist