MEDICARE: ANDRELL HARRY

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	PST.021645	LA

General Provider Information

NPI Number	:	1679027981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDRELL HARRY

Provider Business Mailing Address
First Line	:	2728 BAY ST
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70122-5902
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 ELYSIAN FIELDS AVE
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70117-8209
Country	:	US
Telephone Number	:	504-949-2100
Fax Number	:

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

Provider Enumeration Date	:	08/04/2016
Last Update Date	:	08/04/2016

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Directions to “ ANDRELL HARRY ” Practice Location

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