Aaron Mabou, PHARMD
Individual provider Active NPI Pharmacist · Benton, LA
NPI 1659630788 · NPPES record last updated May 9, 2012
Key facts
- NPI
- 1659630788
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 17395 (LA)
- Practice address
- 6280 Highway 3
Benton, LA 71006-3492 - Phone
- (318) 965-3669
- NPI assigned
- May 9, 2012
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17395 | LA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 17395 | LA | Yes |
Addresses
Primary practice location
6280 Highway 3
Benton, LA 71006-3492
Mailing address
6280 Highway 3
Benton, LA 71006-3492
Phone (318) 965-3669
Other providers in Benton, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.