Provider Demographics
NPI:1720403025
Name:EUBANKS, DELYNN (RPH)
Entity type:Individual
Prefix:
First Name:DELYNN
Middle Name:
Last Name:EUBANKS
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 1:300 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:WINNSBORO
Mailing Address - State:LA
Mailing Address - Zip Code:71295-2034
Mailing Address - Country:US
Mailing Address - Phone:318-435-5000
Mailing Address - Fax:
Practice Address - Street 1:300 ROSE AVE
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2034
Practice Address - Country:US
Practice Address - Phone:318-435-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-23
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15490183500000X
MS8441183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist