Organization
ELBA MEDICAL DIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAISY G. DIMAGGIO RPH (VICE PRESIDENT DIRECTOR OF OPERATIO)
(504) 780-8455
Entity
Organization
Contact information
Practice address
5204 VETERANS BLVD, METAIRIE, LA 70006
(504) 889-9654
(504) 889-6635
Mailing address
5208 VETERANS MEMORIAL BLVD, METAIRIE, LA 70006-5123
(504) 889-7070
(504) 889-7060
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
4360IR
LA
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1234222
—
LA
01
—
19-29629
NCPDP NUMBER
LA
Enumeration date
11/01/2006
Last updated
08/19/2022
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