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Paul Van Deventer MD Apmc — NPI 1104337559, Covington, LA | NPI Central

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NPI 1104337559

OrganizationActive

Paul Van Deventer MD Apmc

NPI 1104337559 · Non-Pharmacy Dispensing Site · Covington, LA

Provider details

NPI number: 1104337559
Entity type: Organization
Primary specialty: Non-Pharmacy Dispensing SiteSuppliers
Authorized official: Mackenzie Hahn, Ncpdp Coordinator
License: MD.025612 (LA)

Practice location

1200 Pinnacle Pkwy Ste 3

Covington, LA 70433-9169

Phone: (479) 636-9702

Fax: (877) 427-2307

More LA providers

Mailing address

Po Box 3328

Bentonville, AR 72712

Registry dates

Enumerated: 2017-10-12
Last updated: 2017-11-16

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.