Healthcare Provider Details

I. General information

NPI: 1225545957
Provider Name (Legal Business Name): JONATHAN LLOYD HARTMANN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 01/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

515 1/2 AURORA AVE
METAIRIE LA
70005-3213
US

V. Phone/Fax

Practice location:
  • Phone: 866-624-7637
  • Fax:
Mailing address:
  • Phone: 504-494-0051
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPST.022100
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: