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NPI Code Detail

MEDICARE: GENA M. TERRITO-TYNES PHARM D.

MEDICARE: GENA M. TERRITO-TYNES PHARM D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist16166LA

General Provider Information

NPI Number : 1073745915
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENA M. TERRITO-TYNES PHARM D.
Provider Business Mailing Address
First Line : 2268 SUNSET BLVD
Second Line :
City : SLIDELL
State : LA
Zip : 70461-5604
Country : US
Telephone Number : 504-914-7002
Fax Number :
Provider Business Practice Location Address
First Line : 4115 JEFFERSON HWY
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70121-1533
Country : US
Telephone Number : 504-842-1900
Fax Number : 504-842-1901
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2009
Last Update Date : 07/11/2019

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Directions to “ GENA M. TERRITO-TYNES PHARM D.” Practice Location

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