Provider Demographics
NPI:1144503251
Name:ENDLER, ANNETTE (R PH)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:ENDLER
Suffix:
Gender:F
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 ROBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2009
Mailing Address - Country:US
Mailing Address - Phone:985-643-7894
Mailing Address - Fax:
Practice Address - Street 1:999 ROBERT BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2009
Practice Address - Country:US
Practice Address - Phone:985-643-7894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2011-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14040183500000X
MST010481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist