NPI 1083839187

Chris Joseph Ivanyisky, RPH

Practitioner Pharmacist Mandeville, LA

Practice location

Address: 23515 Hwy 190, Mandeville, LA 70470
Phone: (985) 626-6300
Fax: (985) 626-6639
Mailing address: PO Box 3850 23515 Hwy 190, Mandeville, LA 70470-3550

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 16117 (LA)

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Registry record

NPI: 1083839187
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Apr 2007
Record last updated: 8 Jul 2007

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.