Doctor Name: | HENOK MEKONEN |
NPI Number: | 1154707297 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHARMD |
License Number: | PNT. 047751 |
Business Practice Address: | 4444 Jackson St Alexandria, LA - 713032708 |
Business Phone Number: | 3184489340 |
Business Fax Number: | |
Mailing Address: | 4040 Parliament Dr Apt 239, ALEXANDRIA |
State: | LA |
Postal Code: | 713033062 |
Phone Number: | 3127144692 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2015 |
NPI Last Update Date: | 07/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | PNT. 047751 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |