Provider Demographics
NPI:1104156835
Name:BURRELL, HERBERT (PHARM D)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:
Last Name:BURRELL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1537 N CLAIBORNE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70116-1339
Mailing Address - Country:US
Mailing Address - Phone:504-942-8700
Mailing Address - Fax:504-942-8701
Practice Address - Street 1:8636 MARKS ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-4628
Practice Address - Country:US
Practice Address - Phone:504-942-8700
Practice Address - Fax:504-942-8701
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2009-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17135183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist