Provider Demographics
NPI:1487211462
Name:ABSOLUTE HEALTH & WELLNESS PHARMACY LLC
Entity Type:Organization
Organization Name:ABSOLUTE HEALTH & WELLNESS PHARMACY LLC
Other - Org Name:ABSOLUTE HEALTH & WELLNESS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:TERIONE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-324-9229
Mailing Address - Street 1:6721 ST. CLAUDE AVENUE SUITE A
Mailing Address - Street 2:
Mailing Address - City:ARABI
Mailing Address - State:LA
Mailing Address - Zip Code:70032-2826
Mailing Address - Country:US
Mailing Address - Phone:504-324-9229
Mailing Address - Fax:504-302-9228
Practice Address - Street 1:6721 ST. CLAUDE AVENUE SUITE A
Practice Address - Street 2:
Practice Address - City:ARABI
Practice Address - State:LA
Practice Address - Zip Code:70032
Practice Address - Country:US
Practice Address - Phone:504-324-9229
Practice Address - Fax:504-302-9228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-24
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy