Provider Demographics
NPI:1922511005
Name:ANGU, ANTHONY FRU
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:FRU
Last Name:ANGU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 FINNEGAN WAY
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-6831
Mailing Address - Country:US
Mailing Address - Phone:443-735-6138
Mailing Address - Fax:
Practice Address - Street 1:911 MAIN ST
Practice Address - Street 2:
Practice Address - City:ELTON
Practice Address - State:LA
Practice Address - Zip Code:70532-3228
Practice Address - Country:US
Practice Address - Phone:337-584-2256
Practice Address - Fax:337-584-2499
Is Sole Proprietor?:No
Enumeration Date:2017-11-10
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAPST.023874OtherLOUISIANA BOARD OF PHARMACY