Healthcare Provider Details

I. General information

NPI: 1427948926
Provider Name (Legal Business Name): ASCENSION DEPAUL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3715 WILLIAMS BLVD STE 100
KENNER LA
70065-3066
US

IV. Provider business mailing address

PO BOX 4148
NEW ORLEANS LA
70178-4148
US

V. Phone/Fax

Practice location:
  • Phone: 504-305-2650
  • Fax: 504-484-0834
Mailing address:
  • Phone: 504-305-2650
  • Fax: 504-486-6016

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: MICHAEL GRIFFIN
Title or Position: PRESIDENT
Credential:
Phone: 504-207-3059