Provider Demographics
NPI:1295105617
Name:OCHSNER PHARMACY AND WELLNESS LLC
Entity type:Organization
Organization Name:OCHSNER PHARMACY AND WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EVP AND COO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HULEFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-842-5898
Mailing Address - Street 1:13100 RIVER RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-5219
Mailing Address - Country:US
Mailing Address - Phone:985-240-4610
Mailing Address - Fax:985-240-4616
Practice Address - Street 1:13100 RIVER RD STE 110
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-5216
Practice Address - Country:US
Practice Address - Phone:985-240-4610
Practice Address - Fax:985-240-4616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
LAPHY-007179-RC333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2154892OtherPK