Healthcare Provider Details

I. General information

NPI: 1942301742
Provider Name (Legal Business Name): GEORGETTE S KHALIL PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 PERDIDO ST
NEW ORLEANS LA
70112-1262
US

IV. Provider business mailing address

5961 WRIGHT RD
NEW ORLEANS LA
70128-2713
US

V. Phone/Fax

Practice location:
  • Phone: 504-568-0811
  • Fax: 504-310-6200
Mailing address:
  • Phone: 504-568-0811
  • Fax: 504-310-6200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number10184
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: