MEDICARE: DR. HERBERT BURRELL 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
1	183500000X	Pharmacist	17135	LA

General Provider Information

NPI Number	:	1104156835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERBERT BURRELL PHARM. D

Provider Business Mailing Address
First Line	:	1537 N CLAIBORNE AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70116-1339
Country	:	US
Telephone Number	:	504-942-8700
Fax Number	:	504-942-8701

Provider Business Practice Location Address
First Line	:	8636 MARKS ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70118-4628
Country	:	US
Telephone Number	:	504-942-8700
Fax Number	:	504-942-8701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	12/31/2009

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