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
- Last updated
- 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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
- Ochsner Pharmacy and Wellness LLC (Ochsner Pharmacy and Wellness- West Bank)
- Desmond Patrick Oconnor, LPC,LMFT
- James D Okun, MD
- Old Gretna Pharmacy, LLC (Old Gretna Pharmacy)
- Michael Olusegun Olusanya, PLPC
- Adesola Omole
- Ops Family Care, LLC
- Orthotic Prosthetic Solutions LLC
- Dewanda Owens
- Brandon Page, MD
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.