Individual provider Active NPI

Hun Pham Phan, PHARMD

  • Pharmacist
  • New Orleans, LA
National Provider Identifier
1255850590
Registry record updated Sep 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
022205 Issued in LA
Practice address
1100 Elysian Fields Ave
New Orleans, LA 70117-8404
Phone
(504) 943-9788
NPI assigned
Sep 19, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 022205 LA Primary

Addresses

Primary practice location

1100 Elysian Fields Ave
New Orleans, LA 70117-8404

Mailing address

13534 Lourdes St
New Orleans, LA 70129-1512
Phone (504) 451-6304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
022205LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Louisiana Co Inc Past Accepting new patients
Walgreen Louisiana Co Inc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505779200000",
    "number": "1255850590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13534 LOURDES ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701291512",
            "telephone_number": "504-451-6304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ELYSIAN FIELDS AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701178404",
            "telephone_number": "504-943-9788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHAN",
        "first_name": "HUN",
        "middle_name": "PHAM",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2017-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "022205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.