MEDICARE: LAKEFRONT 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	333600000X	Pharmacy	5525	LA
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1932234	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558439794
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEFRONT PHARMACY

Provider Business Mailing Address
First Line	:	6510 SPANISH FORT BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-4322
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6510 SPANISH FORT BLVD
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70124-4322
Country	:	US
Telephone Number	:	504-283-2926
Fax Number	:	504-283-2927

Authorized Official
Title or Position	:	OWNER
Name	:	TED NGUYEN
Credential	:	PHRM
Telephone Number	:	504-283-2926

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	09/11/2025

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Directions to “LAKEFRONT PHARMACY ” Practice Location

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