NPI 1750677126

Elmo Charles Gautreaux, PHARMACIST

Practitioner Pharmacist Larose, LA

Practice location

Address: 13998 W Main St, Larose, LA 70373-3009
Phone: (985) 693-8662
Fax: (985) 693-8867

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 8978 (LA)

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Registry record

NPI: 1750677126
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Jun 2011
Record last updated: 23 Jun 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.