MEDICARE: RANIA MANDO

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	021211	LA

General Provider Information

NPI Number	:	1184175622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANIA MANDO

Provider Business Mailing Address
First Line	:	2908 CLEVELAND AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6312
Country	:	US
Telephone Number	:	504-275-5429
Fax Number	:

Provider Business Practice Location Address
First Line	:	2908 CLEVELAND AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70119-6312
Country	:	US
Telephone Number	:	504-275-5429
Fax Number	:

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

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	10/19/2016

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Directions to “ RANIA MANDO ” Practice Location

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