Healthcare Provider Details

I. General information

NPI: 1487211462
Provider Name (Legal Business Name): ABSOLUTE HEALTH & WELLNESS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 12/28/2019
Certification Date: 12/28/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6721 ST. CLAUDE AVENUE SUITE A
ARABI LA
70032
US

IV. Provider business mailing address

6721 ST. CLAUDE AVENUE SUITE A
ARABI LA
70032-2826
US

V. Phone/Fax

Practice location:
  • Phone: 504-324-9229
  • Fax: 504-302-9228
Mailing address:
  • Phone: 504-324-9229
  • Fax: 504-302-9228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TERIONE M BROCK
Title or Position: PHARMACIST IN CHARGE
Credential:
Phone: 504-324-9229