NPI 1053624692

Brian Patrick Hickey, RPH

Practitioner Pharmacist Mandeville, LA

Practice location

Address: 100 Butternut Ln, Mandeville, LA 70448-1096
Phone: (985) 626-8510

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 14488 (LA)

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Registry record

NPI: 1053624692
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jul 2010
Record last updated: 25 Jul 2010

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.