MEDICARE: LAKEWOOD PHARMACY

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	17383	LA

General Provider Information

NPI Number	:	1407853054
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEWOOD PHARMACY

Provider Business Mailing Address
First Line	:	241 W HARRISON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-1302
Country	:	US
Telephone Number	:	504-486-5418
Fax Number	:	504-486-5416

Provider Business Practice Location Address
First Line	:	241 W HARRISON AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-1302
Country	:	US
Telephone Number	:	504-486-5418
Fax Number	:	504-486-5416

Authorized Official
Title or Position	:	PHARMACIST
Name	:	LAUREN FARSHAD CANTRELLE
Credential	:	PHARMD
Telephone Number	:	504-486-5418

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	08/22/2020

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Directions to “LAKEWOOD PHARMACY ” Practice Location

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