Organization
OLD GRETNA PHARMACY, LLC
Active
Other names
Old Gretna Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY STEELE (MANAGER)
(504) 252-9686
Entity
Organization
Contact information
Practice address
500 LAFAYETTE ST, GRETNA, LA 70053-5936
(504) 252-9686
(504) 252-9839
Mailing address
PO BOX 661, GRETNA, LA 70054-0661
(504) 252-9686
(504) 252-9839
Taxonomy
Speciality
Code
Description
License number
State
3336M0002X
Mail Order Pharmacy
Primary
PHY006869IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2153973
PK
—
Enumeration date
09/11/2015
Last updated
09/11/2015
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