Individual
LYLE BULGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
1635 HWY 3125, GRAMERCY, LA 70052
(225) 869-3651
(225) 968-8826
Mailing address
1635 HWY 3125, P.O. BOX 1511, GRAMERCY, LA 70052
(225) 869-3651
(225) 968-8826
Taxonomy
Speciality
Code
Description
License number
State
1835N1003X
Nutrition Support Pharmacist
Primary
8889
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1917939
NABP
LA
Enumeration date
07/18/2012
Last updated
07/18/2012
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