Provider Demographics
NPI:1861917155
Name:RICAUD, SARAH (PHARMD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RICAUD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4147 BAYOUSIDE DR
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70363-7830
Mailing Address - Country:US
Mailing Address - Phone:985-209-9423
Mailing Address - Fax:
Practice Address - Street 1:3304 CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-7308
Practice Address - Country:US
Practice Address - Phone:318-651-9171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.022096183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAMA.003501OtherLOUISIANA BOARD OF PHARMACY
LAPST.022096OtherLOUISIANA BOARD OF PHARMACY