Provider Demographics
NPI:1386951556
Name:LEMOINE, DEE ANN (RPH)
Entity type:Individual
Prefix:
First Name:DEE
Middle Name:ANN
Last Name:LEMOINE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:DEE
Other - Middle Name:ANN
Other - Last Name:WORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1128 WALL WILLIAMS ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-9037
Mailing Address - Country:US
Mailing Address - Phone:318-348-7834
Mailing Address - Fax:
Practice Address - Street 1:920 OLIVER ROAD WAITING E
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-807-6254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1896187Medicaid
LAMA.000051OtherMEDICATION ADMINISTRATION