Emmanuel Abodoh, PHARM D
Individual provider Active NPI Pharmacist · Shreveport, LA
NPI 1891293890 · NPPES record last updated Jan 25, 2018
Key facts
- NPI
- 1891293890
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PST.022339 (LA)
- Practice address
- 9510 Ellerbe Rd
Shreveport, LA 71106-7406 - Phone
- (318) 797-3272
- NPI assigned
- Jan 25, 2018
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| PST.022339 | LA | MD | Pharmacist |
| 62016 | TX | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients | |
| Louisiana CVS Pharmacy LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 62016 | TX | |
| Pharmacist | 183500000X | PST.022339 | LA | Yes |
Addresses
Primary practice location
9510 Ellerbe Rd
Shreveport, LA 71106-7406
Mailing address
9510 Ellerbe Rd
Shreveport, LA 71106-7406
Phone (318) 797-3272
Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2018. 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.