Provider Demographics
NPI:1730877846
Name:HAROLD, MARIA MARTIN (RPH)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MARTIN
Last Name:HAROLD
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 1:11 GARDERE CT
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-4318
Mailing Address - Country:US
Mailing Address - Phone:504-382-7832
Mailing Address - Fax:
Practice Address - Street 1:9301 BURBANK DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-8604
Practice Address - Country:US
Practice Address - Phone:225-930-5918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist