Provider Demographics
NPI:1982919080
Name:LORMAND, MARGUERITE GRAVOT (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARGUERITE
Middle Name:GRAVOT
Last Name:LORMAND
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 1:1017 E ADMIRAL DOYLE DR
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-6710
Mailing Address - Country:US
Mailing Address - Phone:337-367-9668
Mailing Address - Fax:
Practice Address - Street 1:1017 E ADMIRAL DOYLE DR
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-6710
Practice Address - Country:US
Practice Address - Phone:337-367-9668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15491183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist