Provider Demographics
NPI:1386939239
Name:LATO, RORY BLAISE (RPH)
Entity type:Individual
Prefix:
First Name:RORY
Middle Name:BLAISE
Last Name:LATO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MILLERVILLE RD
Mailing Address - Street 2:T2089
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-1408
Mailing Address - Country:US
Mailing Address - Phone:225-275-2109
Mailing Address - Fax:225-275-2109
Practice Address - Street 1:2001 MILLERVILLE RD
Practice Address - Street 2:T2089
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-1408
Practice Address - Country:US
Practice Address - Phone:225-275-2109
Practice Address - Fax:225-275-2109
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011585183500000X
MST08421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist