Broad Avenue Pharmacy LLC
Pharmacy in New Orleans, LA. Organization (NPI-2).
NPI number1669948162
StatusActive
Last updated in NPPESMay 12, 2020
Details
- NPI
- 1669948162
- Entity type
- Organization (NPI-2)
- Legal business name
- Broad Avenue Pharmacy LLC
- Organization subpart
- No
- Enumeration date
- Oct 23, 2018
- Certification date
- May 12, 2020
- Last updated
- May 12, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | – | – | Yes |
Other names
- Broad Avenue Pharmacy (Doing Business As)
Practice location
1400 N Broad StNew Orleans, LA 70119-2332
Phone 504-309-4388 · Fax 504-309-4389
Mailing address
1400 N Broad StNew Orleans, LA 70119-2332
Phone 504-309-4388
Authorized official
Phat Quach
Pharmacy Manager
5043094388
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