IndividualActive
Mia Ajekwu Bassaragh, PHARM.D.
NPI 1073823449 · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Bossier City, LA
Provider details
- NPI number
- 1073823449
- Entity type
- Individual
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistPharmacy Service Providers
- Credential
- PHARM.D.
- Sex
- Female
- Sole proprietor
- Yes
- License
- 19243 (LA)
Specialties & taxonomies
Pharmacy Service Providers
Practice location
3400 Airline Dr.
Bossier City, LA 71111
Phone: (318) 741-6589
Approximate (ZIP-level) locationGet directions
Mailing address
2940 Le Oaks Drive #1514
Bossier, LA 71111
Registry dates
- Enumerated
- 2010-10-19
- Last updated
- 2010-10-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.