Provider Demographics
NPI:1447673652
Name:LANDRY, ALISON (RPH)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:LANDRY
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 1:14137 BARATARIA AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-5502
Mailing Address - Country:US
Mailing Address - Phone:225-241-7883
Mailing Address - Fax:225-766-7621
Practice Address - Street 1:5255 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-6547
Practice Address - Country:US
Practice Address - Phone:225-766-7778
Practice Address - Fax:225-766-7621
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist