Organization
ESTHER WANDA INC
Active
Other names
KENNER DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER CLARISSE WANDA DOCTOR OF PHARMACY (PHARMACY MANAGER)
(504) 464-4421
Entity
Organization
Contact information
Practice address
3108 LOYOLA DR, KENNER, LA 70065-4139
(504) 464-4421
(504) 469-5995
Mailing address
3108 LOYOLA DR, KENNER, LA 70065-4139
(504) 464-4421
(504) 469-5995
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5319
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1271713
—
LA
Enumeration date
11/02/2006
Last updated
05/10/2010
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