MEDICARE: OLD GRETNA PHARMACY, LLC

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	3336M0002X	Mail Order Pharmacy	PHY006869IR	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2153973	OTHER		PK

General Provider Information

NPI Number	:	1841668530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OLD GRETNA PHARMACY, LLC

Provider Business Mailing Address
First Line	:	PO BOX 661
Second Line	:
City	:	GRETNA
State	:	LA
Zip	:	70054-0661
Country	:	US
Telephone Number	:	504-252-9686
Fax Number	:	504-252-9839

Provider Business Practice Location Address
First Line	:	500 LAFAYETTE ST
Second Line	:
City	:	GRETNA
State	:	LA
Zip	:	70053-5936
Country	:	US
Telephone Number	:	504-252-9686
Fax Number	:	504-252-9839

Authorized Official
Title or Position	:	MANAGER
Name	:	AMY STEELE
Credential	:
Telephone Number	:	504-252-9686

Provider Enumeration Date	:	09/11/2015
Last Update Date	:	09/11/2015

Similar Medicare Providers

1568777563 — AMY STEELE
Practice Location Address:

500 LAFAYETTE ST
GRETNA, LA
70053-5936

Practice Phone: 504-252-9686
Practice Fax: 504-252-9839

1295147130 — MRS. JENA FACIANE
Practice Location Address:

500 LAFAYETTE ST
GRETNA, LA
70053-5936

Practice Phone: 504-252-9686
Practice Fax:

1699205138 — MR. CHAD M RUDOLPH PHARM D.
Practice Location Address:

500 LAFAYETTE ST
GRETNA, LA
70053-5936

Practice Phone: 504-252-9686
Practice Fax:

1295005486 — MR. LIONEL LOUIS FASCIO II LMSW
Practice Location Address:

1400 CALDER ST
GRETNA, LA
70053-5637

Practice Phone: 504-322-7710
Practice Fax: 504-322-7708

1053249128 — BETHANY GABRIELLE DEAIRY LMSW
Practice Location Address:

2550 BELLE CHASSE HWY STE 220
GRETNA, LA
70053-6733

Practice Phone: 504-367-6888
Practice Fax:

1336129923 — ERROL M. BLOOM O.D.
Practice Location Address:

80 WESTBANK EXPY
GRETNA, LA
70053-3654

Practice Phone: 504-366-9435
Practice Fax: 504-368-5585

Directions to “OLD GRETNA PHARMACY, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.