Organization
M D PHARMACY INC
Active
Other names
MD PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FAZENDE (OWNER)
(504) 340-7744
Entity
Organization
Contact information
Practice address
712 WESTBANK EXPY, WESTWEGO, LA 70094-4400
(504) 340-1110
(504) 340-5188
Mailing address
712 WESTBANK EXPY, WESTWEGO, LA 70094-4400
(504) 340-1110
(504) 340-5188
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
4699
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1268933
—
LA
01
—
1930343
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/31/2006
Last updated
03/05/2010
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