Organization
BROAD AVENUE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHAT KIM QUACH (VICE-PRESIDENT AND PHARMACIST)
(504) 231-4796
Entity
Organization
Contact information
Practice address
1400 NORTH BROAD AVENUE, NEW ORLEANS, LA 70119
(504) 309-4388
(504) 309-4389
Mailing address
1400 NORTH BROAD AVENUE, NEW ORLEANS, LA 70119
(504) 309-4388
(504) 309-4389
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5757
LA
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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