Provider Demographics
NPI:1538242466
Name:BAJON, CHARLTON ANDREW JR (PHARMACIST)
Entity type:Individual
Prefix:DR
First Name:CHARLTON
Middle Name:ANDREW
Last Name:BAJON
Suffix:JR
Gender:M
Credentials:PHARMACIST
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:32425 SONNY BARBIER ST
Mailing Address - Street 2:
Mailing Address - City:WHITE CASTLE
Mailing Address - State:LA
Mailing Address - Zip Code:70788-2413
Mailing Address - Country:US
Mailing Address - Phone:225-545-2226
Mailing Address - Fax:225-545-2220
Practice Address - Street 1:32020 BOWIE ST
Practice Address - Street 2:
Practice Address - City:WHITE CASTLE
Practice Address - State:LA
Practice Address - Zip Code:70788-2406
Practice Address - Country:US
Practice Address - Phone:225-545-2226
Practice Address - Fax:225-545-2220
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA12054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist