Provider Demographics
NPI:1689344772
Name:ST. PAULS PHARMACY INC
Entity Type:Organization
Organization Name:ST. PAULS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:504-329-0520
Mailing Address - Street 1:3525 BIENVILLE ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5249
Mailing Address - Country:US
Mailing Address - Phone:504-603-2623
Mailing Address - Fax:504-603-2623
Practice Address - Street 1:3525 BIENVILLE ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5249
Practice Address - Country:US
Practice Address - Phone:504-603-2623
Practice Address - Fax:504-603-2623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-20
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy