Individual
MR. TALMADGE R GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.D.
Contact information
Practice address
1414 JACKSON ST, ALEXANDRIA, LA 71301-6931
(318) 442-4485
(318) 443-6410
Mailing address
1414 JACKSON ST, ALEXANDRIA, LA 71301-6931
(318) 442-4485
(318) 443-6410
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11049
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234869
—
LA
01
—
1903360
NABP
—
01
—
914-IR
LA PHARMACY PERMIT NO.
LA
Enumeration date
10/20/2006
Last updated
02/06/2015
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