Malcolm J Broussard
Pharmacist in Baton Rouge, LA. Individual provider (NPI-1).
NPI number1346241007
StatusActive
Last updated in NPPESApr 7, 2011
Details
- NPI
- 1346241007
- Entity type
- Individual (NPI-1)
- Name
- Mr. Malcolm J Broussard
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 3, 2005
- Last updated
- Apr 7, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 11396 | LA | Yes |
Practice location
3388 Brentwood DrBaton Rouge, LA 70809-1700
Phone 225-925-6481 · Fax 225-922-0316
Mailing address
3388 Brentwood DrBaton Rouge, LA 70809-1700
Phone 225-925-6481 · Fax 225-922-0316
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