Provider Demographics
NPI:1013568047
Name:OCHSNER PHARMACY AND WELLNESS LLC
Entity Type:Organization
Organization Name:OCHSNER PHARMACY AND WELLNESS LLC
Other - Org Name:OCHSNER PHARMACY AND WELLNESS- SLIDELL MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR RETAIL PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROVIRA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:504-842-8623
Mailing Address - Street 1:1051 GAUSE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2951
Mailing Address - Country:US
Mailing Address - Phone:985-639-3726
Mailing Address - Fax:504-842-3141
Practice Address - Street 1:1051 GAUSE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2951
Practice Address - Country:US
Practice Address - Phone:985-639-3726
Practice Address - Fax:985-639-3729
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OCHSNER PHARMACY AND WELLNESS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-20
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy