Individual
MRS. JACQUELINE FRANCES BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
213 HOSPITAL RD, WINN DIXIE PHARMACY #1572, NEW ROADS, LA 70760
(225) 638-5151
(225) 638-5148
Mailing address
412 PECAN ST, NEW ROADS, LA 70760
(225) 618-0635
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11853
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1262455
—
LA
Enumeration date
09/13/2006
Last updated
07/08/2007
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