Chad M Rudolph, PHARM D.

Primary specialty

PharmacistTaxonomy code 183500000X

License

17966 Issued in LA

Practice address

500 Lafayette St
Gretna, LA 70053-5936

Phone

(504) 252-9686

NPI assigned

Jun 18, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Chad M Rudolph Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Old Gretna Pharmacy, LLC

  • Mail Order Pharmacy
  • Gretna, LA
  • NPI 1841668530
  NPD (past)

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497744000000",
    "number": "1699205138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 CAITLIN CT",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700724055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LAFAYETTE ST",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700535936",
            "telephone_number": "504-252-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOLPH",
        "first_name": "CHAD",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PHARM D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "17966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHAD",
            "last_name": "RUDOLPH",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "PHARM D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• J. Michael Rooney, D.D.S.
• Monica Hull Rose, LPC, NCC
• Henry L Rosenberg, MD
• Edwin B. Ross Jr., MD
• Stephanie Roubion
• Natha Lee Ruffin
• Russell Schafer Dental Clinic LLC
• Glenn Gerard Russo, M.D.
• Gordon J Russo, MD
• Peter Russo

• Pharmacist in Gretna, LA
• Providers in Gretna, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.