Provider Demographics
NPI:1124333505
Name:DESAI, BINITA M (RPH)
Entity type:Individual
Prefix:MRS
First Name:BINITA
Middle Name:M
Last Name:DESAI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12881 PERKINS RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1913
Mailing Address - Country:US
Mailing Address - Phone:225-763-6281
Mailing Address - Fax:225-763-6036
Practice Address - Street 1:12881 PERKINS RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1913
Practice Address - Country:US
Practice Address - Phone:225-763-6281
Practice Address - Fax:225-763-6036
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017224183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist