Individual
JEREMY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
5101 SHREVEPORT HWY, PINEVILLE, LA 71360-3525
(318) 769-9751
Mailing address
5101 SHREVEPORT HWY, PINEVILLE, LA 71360-3525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16108
LA
Other
Enumeration date
08/12/2010
Last updated
10/27/2023
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