Healthcare Provider Details

I. General information

NPI: 1073981734
Provider Name (Legal Business Name): MEADOWCREST PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 MEADOWCREST ST # A-1
GRETNA LA
70056-5256
US

IV. Provider business mailing address

866 MARLENE DR
GRETNA LA
70056-7642
US

V. Phone/Fax

Practice location:
  • Phone: 504-323-2350
  • Fax: 504-301-0773
Mailing address:
  • Phone: 504-323-2350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number7176-IR
License Number StateLA

VIII. Authorized Official

Name: MS. ADRIENNE TRAN
Title or Position: OWNER/PHARMACIST
Credential: PD
Phone: 504-323-2350