Individual
MR. RONALD JOSEPH BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
3131 STAGG, BASILE, LA 70515
(337) 432-6642
(337) 432-6606
Mailing address
PO BOX 426, BASILE, LA 70515-0426
(337) 432-6642
(337) 432-6606
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
8958
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1262927
—
LA
Enumeration date
11/01/2006
Last updated
07/08/2007
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