NPI 1023390168

Richard P Frederickson02/

Practitioner Pharmacist Mandeville, LA

Practice location

Address: 4540 Highway 22, Mandeville, LA 70471-3300
Phone: (985) 674-3320

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 11041 (LA)

Other Pharmacist providers in Louisiana →

Registry record

NPI: 1023390168
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Sep 2011
Record last updated: 14 Sep 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.