Provider Demographics
NPI:1003191610
Name:RELAN, JULIE STORC
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:STORC
Last Name:RELAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-1609
Mailing Address - Country:US
Mailing Address - Phone:504-433-5033
Mailing Address - Fax:
Practice Address - Street 1:3621 GENERAL DEGAULLE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6716
Practice Address - Country:US
Practice Address - Phone:504-362-0700
Practice Address - Fax:504-362-3315
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist