MEDICARE: DR. RICHARD ANDERSON JR. PHARMD

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	020664	LA

General Provider Information

NPI Number	:	1437568342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD ANDERSON JR. PHARMD

Provider Business Mailing Address
First Line	:	5004 WEST ESPLANADE AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006
Country	:	US
Telephone Number	:	504-888-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	5004 WEST ESPLANADE AVE
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70006
Country	:	US
Telephone Number	:	504-888-9000
Fax Number	:

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

Provider Enumeration Date	:	08/05/2014
Last Update Date	:	08/05/2014

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