Healthcare Provider Details

I. General information

NPI: 1023846300
Provider Name (Legal Business Name): JILL ANN ROVIRA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 JEFFERSON HWY STE A
NEW ORLEANS LA
70121-2448
US

IV. Provider business mailing address

612 METAIRIE LAWN DR
METAIRIE LA
70001-2923
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-7439
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.025385
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: