Healthcare Provider Details

I. General information

NPI: 1093627010
Provider Name (Legal Business Name): AL IFTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2726 JOSEPHINE ST
NEW ORLEANS LA
70113-2912
US

IV. Provider business mailing address

2726 JOSEPHINE ST
NEW ORLEANS LA
70113-2912
US

V. Phone/Fax

Practice location:
  • Phone: 504-531-2624
  • Fax:
Mailing address:
  • Phone: 504-531-2624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number
License Number State

VIII. Authorized Official

Name: MS. EMERALD M WATSON
Title or Position: CEO
Credential: MD
Phone: 504-531-2624