Healthcare Provider Details

I. General information

NPI: 1427409127
Provider Name (Legal Business Name): OCHSNER PHARMACY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2016
Last Update Date: 02/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ESPLANADE AVE STE 106
KENNER LA
70065-2473
US

IV. Provider business mailing address

1405 JEFFERSON HWY
JEFFERSON LA
70121-2426
US

V. Phone/Fax

Practice location:
  • Phone: 504-464-8250
  • Fax: 504-464-8251
Mailing address:
  • Phone: 504-464-8250
  • Fax: 504-464-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY-007340-RC
License Number StateLA

VIII. Authorized Official

Name: RICHARD ROVIRA
Title or Position: DIRECTOR
Credential:
Phone: 504-842-8623