Individual
BRYAN W PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
9983 BLUEBONNET BLVD, BATON ROUGE, LA 70810-6458
(225) 769-4208
Mailing address
361 GLENMORE AVE, BATON ROUGE, LA 70806-5217
(901) 355-6914
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.019271
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1079256
WALGREENS
LA
01
—
MA001133
LOUISIANA BOARD OF PHARMACY
LA
01
—
PST091271
LOUISIANA BOARD OF PHARMACY
LA
Enumeration date
10/25/2010
Last updated
10/25/2010
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