Organization
IDEAL PHARMACY CARE INC
Active
Other names
ESPLANADE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CONRAD CHARLES (MANAGER)
(504) 523-4103
Entity
Organization
Contact information
Practice address
1400 ESPLANADE AVE, NEW ORLEANS, LA 70116-1803
(504) 523-4103
(504) 523-5910
Mailing address
1400 ESPLANADE AVE, NEW ORLEANS, LA 70116-1803
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6007IR
LA
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1908788
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/18/2006
Last updated
11/21/2008
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