Provider Demographics
NPI:1174707319
Name:BAHAM, JANENE PATRICE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JANENE
Middle Name:PATRICE
Last Name:BAHAM
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 ALINE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-1211
Mailing Address - Country:US
Mailing Address - Phone:504-214-8219
Mailing Address - Fax:
Practice Address - Street 1:801 ALINE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-1211
Practice Address - Country:US
Practice Address - Phone:504-214-8219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-24
Last Update Date:2007-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16303183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist