Healthcare Provider Details

I. General information

NPI: 1467908301
Provider Name (Legal Business Name): OCHSNER PHARMACY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 ACADIA PARK DR
RACELAND LA
70394-2618
US

IV. Provider business mailing address

108 ACADIA PARK DR
RACELAND LA
70394-2618
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-8326
  • Fax: 504-842-8477
Mailing address:
  • Phone: 504-842-8326
  • Fax: 504-842-8477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License NumberPHY.007343-RC
License Number StateLA

VIII. Authorized Official

Name: RICHARD ROVIRA
Title or Position: DIRECTOR
Credential:
Phone: 504-842-8623