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NPI Code Detail

MEDICARE: DENNIS LUKE ORTEGO RPH

MEDICARE: DENNIS LUKE ORTEGO RPH
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
1183500000XPharmacist9720LA

General Provider Information

NPI Number : 1104181544
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS LUKE ORTEGO RPH
Provider Business Mailing Address
First Line : 1210 ALBERTSON PKWY
Second Line :
City : BROUSSARD
State : LA
Zip : 70518
Country : US
Telephone Number : 337-839-0530
Fax Number : 337-839-1432
Provider Business Practice Location Address
First Line : 1210 ALBERTSON PKWY
Second Line :
City : BROUSSARD
State : LA
Zip : 70518-4347
Country : US
Telephone Number : 337-839-0530
Fax Number : 337-839-1432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2012
Last Update Date : 07/11/2012

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Directions to “ DENNIS LUKE ORTEGO RPH” Practice Location

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