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NPI Code Detail

MEDICARE: MR. HENRY PHILLIP ROUQUETTE PHARMACIST

MEDICARE: MR. HENRY PHILLIP ROUQUETTE PHARMACIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist13561LA

General Provider Information

NPI Number : 1215242250
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. HENRY PHILLIP ROUQUETTE PHARMACIST
Provider Business Mailing Address
First Line : 7101 VETERANS MEMORIAL BLVD
Second Line :
City : METAIRIE
State : LA
Zip : 70003-4430
Country : US
Telephone Number : 504-455-2431
Fax Number : 504-455-5373
Provider Business Practice Location Address
First Line : 7101 VETERANS MEMORIAL BLVD
Second Line :
City : METAIRIE
State : LA
Zip : 70003-4430
Country : US
Telephone Number : 504-455-2431
Fax Number : 504-455-5373
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2010
Last Update Date : 08/14/2010

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