Provider Demographics
NPI:1538355581
Name:DUFRENE, BRIAN A (RPH)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:DUFRENE
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 1:6200 MARSHALL FOCH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3816
Mailing Address - Country:US
Mailing Address - Phone:985-414-1642
Mailing Address - Fax:
Practice Address - Street 1:6200 MARSHALL FOCH ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70124-3816
Practice Address - Country:US
Practice Address - Phone:985-414-1642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-23
Last Update Date:2007-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA10102183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist