Individual
VIVIANNE PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12880 AIRLINE HWY, BATON ROUGE, LA 70817-5105
(225) 751-3611
Mailing address
12880 AIRLINE HWY, BATON ROUGE, LA 70817-5105
(225) 751-3611
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.026207
LA
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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