Provider Demographics
NPI:1962918144
Name:SCHAFF, CHARLES F III
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:SCHAFF
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 COVINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70447-9683
Mailing Address - Country:US
Mailing Address - Phone:985-206-9425
Mailing Address - Fax:985-335-1209
Practice Address - Street 1:211 COVINGTON ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:LA
Practice Address - Zip Code:70447-9683
Practice Address - Country:US
Practice Address - Phone:985-206-9425
Practice Address - Fax:985-335-1209
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-25
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist