Provider Demographics
NPI:1215244199
Name:CASEY, ANDREA DESFORGES (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DESFORGES
Last Name:CASEY
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 1:8601 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:RIVER RIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70123-3510
Mailing Address - Country:US
Mailing Address - Phone:504-738-5785
Mailing Address - Fax:
Practice Address - Street 1:8601 JEFFERSONN HIGHWAY
Practice Address - Street 2:
Practice Address - City:RIVER RIDGE
Practice Address - State:LA
Practice Address - Zip Code:70123
Practice Address - Country:US
Practice Address - Phone:504-738-5785
Practice Address - Fax:504-738-5889
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist