Provider Demographics
NPI:1881954089
Name:NOLA DISCOUNT PHARMACY LLC
Entity type:Organization
Organization Name:NOLA DISCOUNT PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:COLE
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-473-3714
Mailing Address - Street 1:4305 CLEARVIEW PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2762
Mailing Address - Country:US
Mailing Address - Phone:504-888-9411
Mailing Address - Fax:504-888-9410
Practice Address - Street 1:4305 CLEARVIEW PKWY STE B
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2762
Practice Address - Country:US
Practice Address - Phone:504-888-9411
Practice Address - Fax:504-888-9410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-22
Last Update Date:2025-04-22
Deactivation Date:2019-03-12
Deactivation Code:
Reactivation Date:2019-03-18
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY.006518-IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2201492Medicaid
2135280OtherPK