Healthcare Provider Details

I. General information

NPI: 1952459901
Provider Name (Legal Business Name): ASCENSION DEPAUL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N CAUSEWAY BLVD
METAIRIE LA
70001-5450
US

IV. Provider business mailing address

PO BOX 4148
NEW ORLEANS LA
70178-4148
US

V. Phone/Fax

Practice location:
  • Phone: 504-488-3007
  • Fax: 504-212-1197
Mailing address:
  • Phone: 504-488-3007
  • Fax: 504-212-1197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License NumberPHY.003542-IR
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL GRIFFIN
Title or Position: CEO
Credential:
Phone: 504-482-2080