Active NPI
Osaro Antony Omofomwan
- Pharmacist
- Gretna, LA
National Provider Identifier
1306639166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PST.025738
- Practice address
- 2001 Carol Sue Ave
Gretna, LA 70056-4445 - Phone
- (504) 366-1535
- NPI assigned
- May 26, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PST.025738 | LA | Primary |
Addresses
Primary practice location
2001 Carol Sue Ave
Gretna, LA 70056-4445
Mailing address
2228 Timbers Dr
Harvey, LA 70058-2228
Phone (504) 799-9581
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PST.025738 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2001 Carol Sue Ave
Gretna, LA 70056
Phone (504) 366-1535
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.
-
- Pharmacy
- Gretna, LA
- NPI 1497760656
-
- Pharmacy
- Longview, TX
- NPI 1629956545
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748217600000",
"number": "1306639166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2228 TIMBERS DR",
"city": "HARVEY",
"state": "LA",
"postal_code": "700582228",
"telephone_number": "504-799-9581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 CAROL SUE AVE",
"city": "GRETNA",
"state": "LA",
"postal_code": "700564445",
"telephone_number": "504-366-1535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OMOFOMWAN",
"first_name": "OSARO",
"middle_name": "ANTONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-26",
"last_updated": "2025-05-26",
"certification_date": "2025-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "PST.025738",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gretna, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.