Provider Demographics
NPI:1386929503
Name:GOODELL, ARLOND WESLEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ARLOND
Middle Name:WESLEY
Last Name:GOODELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 BENOIT LN
Mailing Address - Street 2:#14
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-4273
Mailing Address - Country:US
Mailing Address - Phone:563-210-3452
Mailing Address - Fax:
Practice Address - Street 1:2636 RYAN ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7326
Practice Address - Country:US
Practice Address - Phone:337-433-4178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.019652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist