Old Gretna Pharmacy, LLC

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

License

PHY006869IR Issued in LA

Legal business name

OLD GRETNA PHARMACY, LLC

Doing business as

Old Gretna Pharmacy

Practice address

500 Lafayette St
Gretna, LA 70053-5936

Phone

(504) 252-9686

Fax

(504) 252-9839

NPI assigned

Sep 11, 2015

Last updated

Sep 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amy SteeleNPI 1568777563

Title

Manager

Phone

(504) 252-9686

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Old Gretna Pharmacy Doing business as

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amy Steele

  • Pharmacist
  • Gretna, LA
  • NPI 1568777563
  NPD (past) Authorized official
• Jena Faciane

  • Pharmacist
  • Gretna, LA
  • NPI 1295147130
  NPD (past)
• Chad M Rudolph, PHARM D.

  • Pharmacist
  • Gretna, LA
  • NPI 1699205138
  NPD (past)

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

{
    "created_epoch": "1441929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441929600000",
    "number": "1841668530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 661",
            "city": "GRETNA",
            "state": "LA",
            "postal_code": "700540661",
            "telephone_number": "504-252-9686",
            "fax_number": "504-252-9839"
        },
        {
            "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",
            "fax_number": "504-252-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD GRETNA PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-11",
        "last_updated": "2015-09-11",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "504-252-9686"
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": "LA",
            "license": "PHY006869IR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153973",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Gretna Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mail Order Pharmacy in Gretna, LA
• Providers in Gretna, LA by specialty
• Mail Order Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2015; 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.