Provider Demographics
NPI:1760292809
Name:RABB, STEWART CORNELIUS (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:STEWART
Middle Name:CORNELIUS
Last Name:RABB
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 QUIMPER PL STE 300
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5742
Mailing Address - Country:US
Mailing Address - Phone:318-671-9303
Mailing Address - Fax:318-671-1106
Practice Address - Street 1:8720 QUIMPER PL STE 300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5742
Practice Address - Country:US
Practice Address - Phone:318-671-9303
Practice Address - Fax:318-671-1106
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.018219183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist