Healthcare Provider Details

I. General information

NPI: 1295105617
Provider Name (Legal Business Name): OCHSNER PHARMACY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2015
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13100 RIVER RD STE 110
DESTREHAN LA
70047-5216
US

IV. Provider business mailing address

13100 RIVER RD SUITE 110
DESTREHAN LA
70047-5219
US

V. Phone/Fax

Practice location:
  • Phone: 985-240-4610
  • Fax: 985-240-4616
Mailing address:
  • Phone: 985-240-4610
  • Fax: 985-240-4616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY-007179-RC
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL HULEFELD
Title or Position: EVP AND COO
Credential:
Phone: 504-842-5898