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General NPI Number Information
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NPI Number | 1043337538
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Entity Type | Individual
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Provider Name | GREGORY J DOLESE R.PH.
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Gender | Male
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 07/28/2011
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Provider Practice Location Address
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Address Line | 4052 HWY 951 200 BUILDING
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City | JACKSON
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State | LA
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Zip | 70748
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Country | US
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Telephone | 225-634-0370
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Fax | 225-634-0521
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Provider Business Mailing Address
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Address Line | 1449 POINSETTA ST
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City | METAIRIE
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State | LA
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Zip | 70005-1030
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14728
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License Number State | LA
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