M D Pharmacy Inc

Organization Active NPI Community/Retail Pharmacy · Westwego, LA

NPI 1487766473 · NPPES record last updated Mar 5, 2010

Key facts

NPI
1487766473
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
4699 (LA)
Legal business name
M D PHARMACY INC
Practice address
712 Westbank Expy
Westwego, LA 70094-4400
Phone
(504) 340-1110
Fax
(504) 340-5188
NPI assigned
Aug 31, 2006
Organization subpart
No

Authorized official

Name
Michael Fazende
Title
Owner
Phone
(504) 340-7744

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 4699 LA Yes

Addresses

Primary practice location

712 Westbank Expy
Westwego, LA 70094-4400

Mailing address

712 Westbank Expy
Westwego, LA 70094-4400
Phone (504) 340-1110

Other identifiers

IdentifierTypeStateIssuer
1268933MedicaidLA
1930343OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names

  • MD PHARMACY INC Doing business as

Other providers in Westwego, LA

All providers in Westwego, LA · Community/Retail Pharmacy in Louisiana

Sources for this page

Verify at the official NPI Registry.