Healthcare Provider Details

I. General information

NPI: 1932501038
Provider Name (Legal Business Name): MBP GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2014
Last Update Date: 06/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8138 OAK ST
NEW ORLEANS LA
70118
US

IV. Provider business mailing address

8138 OAK ST
NEW ORLEANS LA
70118-2040
US

V. Phone/Fax

Practice location:
  • Phone: 504-324-4343
  • Fax: 504-301-2950
Mailing address:
  • Phone: 504-324-4343
  • Fax: 504-301-2950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW PLAISANCE
Title or Position: PIC
Credential: RPH
Phone: 504-324-4343