BROAD AVENUE PHARMACY LLC (NPI# 1669948162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669948162 |
| Entity Type | Organization |
| Organization Name | BROAD AVENUE PHARMACY LLC |
| Practice Address |
1400 N Broad St New Orleans LA 70119-2332 |
| Practice Telephone | 5043094388 |
| Practice Fax Number | 5043094389 |
| Mailing Telephone | 5043094388 |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | PHAT QUACH (PHARMACY MANAGER) |
| Authorized Official Telephone | 5043094388 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| Broad Avenue Pharmacy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396879003 | Broad Avenue Pharmacy LLC | Pharmacist | 1400 North Broad Avenue, New Orleans, LA 70119 | 2007-03-15 |
| 1184661589 | Broad Avenue Pharmacy LLC | Pharmacy | 2329 Broad Ave, Altoona, PA 16601-1979 | 2006-06-02 |
| Street Address |
1400 N BROAD ST |
| City | NEW ORLEANS |
| State | LA |
| Zip Code | 70119-2332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578161105 | Mark P Kostelak | Perfusionist | Southeast Louisiana Veterans Health Care System, 2400 Canal Street, New Orleans, LA 70119 | 2020-10-15 |
| 1922626365 | Shanika Valcour-leduff | Nurse Practitioner | 535 S Galvez St., New Orleans, LA 70119 | 2020-07-13 |
| 1932723335 | Just Health | Clinic/Center | 2800 Perdido St, New Orleans, LA 70119 | 2020-06-01 |
| 1205460235 | Lily Tran | Registered Nurse | 119 S Galvez Street, New Orleans, LA 70119 | 2020-02-28 |
| 1740823137 | Kaylyn Bernard | Case Manager/Care Coordinator | 2626 Canal St., New Orleans, LA 70119 | 2019-10-18 |
| 1114577954 | Alyssia Breion Smith | Case Manager/Care Coordinator | 1995 Gentilly Blvd. Ste. C-400, New Orleans, LA 70119 | 2019-09-13 |
| 1457903387 | Brian Steven Goldfarb | Dentist | 3701 Conti St, Apt #3403, New Orleans, LA 70119 | 2019-07-11 |
| 1013404011 | Made Positive, Inc. | Community/Behavioral Health | 3443 Esplanade Ave., Suite 215, New Orleans, LA 70119 | 2018-04-16 |
| 1972008654 | Griffin Caballero Brown | Student in an Organized Health Care Education/Training Program | 520 Jefferson Davis Hwy, New Orleans, LA 70119 | 2018-03-26 |
| 1902300544 | Kyle Raymond Hoppens | Student in an Organized Health Care Education/Training Program | 4502 Saint Ann Street, New Orleans, LA 70119 | 2018-03-20 |
| Find all providers in zip 70119 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619446523 | Brown Jackson Enterprise LLC | Pharmacy | 3035 1/2 Paris Ave, New Orleans, LA 70119-1715 | 2018-11-20 |
| 1598241424 | Peoples Pharmacy | Pharmacy | 7701 Dwyer Rd Ste 101, New Orleans, LA 70126-4390 | 2018-07-13 |
| 1609388370 | Vu & Nguyen Family 2 LLC | Pharmacy | 10200 Chef Menteur Hwy Ste C, New Orleans, LA 70127-4263 | 2017-11-02 |
| 1518477355 | Votran Rx LLC | Pharmacy | 4646 Michoud Blvd Ste D5, New Orleans, LA 70129-1800 | 2017-10-06 |
| 1497287759 | The Administrators of The Tulane Educational Fund | Pharmacy | 131 S Robertson St Ste 1075, New Orleans, LA 70112-2807 | 2017-03-28 |
| 1962955658 | Ochsner Pharmacy and Wellness LLC | Pharmacy | 2820 Napoleon Ave Ste 220, New Orleans, LA 70115-6969 | 2016-07-28 |
| 1003273392 | Canal Street Pharmacy LLC | Pharmacy | 2525 Canal Street, New Orleans, LA 70119 | 2016-01-19 |
| 1356757256 | Pegasus Biologics LLC | Pharmacy | 5700 Citrus Blvd Ste D, New Orleans, LA 70123-8501 | 2014-07-11 |
| 1073934733 | Express Pharmacy Solutions | Pharmacy | 1441 Canal St, Ste. 201, New Orleans, LA 70112-2714 | 2013-12-26 |
| 1326313404 | Medicine Pro LLC | Pharmacy | 2600 S Claiborne Ave, New Orleans, LA 70125-3921 | 2012-03-21 |
| Find all providers in NEW ORLEANS | ||||
| City | NEW ORLEANS |
| Zip Code | 70119 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.