Organization
FOUNTAIN PARK PHARMACY INC.
Active
Other names
Fountain Park Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JO STEPHANIE CULOTTA PHARMACIST (OWNER/PHARMACIST)
(504) 434-4777
Entity
Organization
Contact information
Practice address
1901 MANHATTAN BLVD, BUILDING F SUITE 104, HARVEY, LA 70058-3582
(504) 434-4777
(504) 309-8031
Mailing address
1901 MANHATTAN BLVD, BUILDING F SUITE 104, HARVEY, LA 70058-3582
(504) 434-4777
(504) 309-8031
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
114250
AL
333600000X
Pharmacy
14022/7.1
MS
333600000X
Pharmacy
15677
SC
333600000X
Pharmacy
22-44626
KS
333600000X
Pharmacy
5277
TN
333600000X
Pharmacy
LA1845
KY
333600000X
Pharmacy
PHY007141IR
LA
3336C0003X
Community/Retail Pharmacy
PH27207
FL
3336C0004X
Compounding Pharmacy
PHNR000702
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142276
PK
—
05
—
2204238
—
LA
Enumeration date
09/19/2013
Last updated
09/01/2016
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