MEDICARE: D. MICHAELLE WOLFE R.PH., C.G.P.

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
1	183500000X	Pharmacist	13375	LA

General Provider Information

NPI Number	:	1518933928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	D. MICHAELLE WOLFE R.PH., C.G.P.

Provider Business Mailing Address
First Line	:	5000 W ESPLANADE AVE
Second Line	:	#334
City	:	METAIRIE
State	:	LA
Zip	:	70006-2551
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5000 W ESPLANADE AVE
Second Line	:	#334
City	:	METAIRIE
State	:	LA
Zip	:	70006-2551
Country	:	US
Telephone Number	:	504-451-6098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	07/08/2007

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