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Organization

ELBA MEDICAL DISTRIBUTORS INC

Active
Other names
Patio Drugs
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DAISY G DIMAGGIO RPH (VICE PRESIDENT DIRECTOR OF OPERATIO)
(504) 780-8455
Entity
Organization

Contact information

Practice address
5208 VETERANS BLVD, METAIRIE, LA 70006
(504) 889-7070
(504) 889-7060
Mailing address
5208 VETERANS BLVD, METAIRIE, LA 70006
(504) 889-7070
(504) 889-7060

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2670IR
LA
3336C0004X
Compounding Pharmacy
2670IR
LA
3336H0001X
Home Infusion Therapy Pharmacy
2670IR
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1260932
LA
01
19-24681
NCPDP NUMBER
LA
01
5CY65
MEDICARE/PART B PTAN
LA
Enumeration date
11/01/2006
Last updated
08/12/2022
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