Organization
TATA LLC
Active
Other names
BUCKTOWN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY DWYER PHARM D (OWNER)
(504) 835-6337
Entity
Organization
Contact information
Practice address
234 W HARRISON AVE, SUITE B, NEW ORLEANS, LA 70124-1303
(504) 835-6337
(504) 846-2556
Mailing address
234 W HARRISON AVE, SUITE B, NEW ORLEANS, LA 70124-1303
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
C005674IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234192
—
LA
01
—
1932905
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/10/2006
Last updated
03/13/2009
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