Provider Demographics
NPI:1154887891
Name:NOLA DISCOUNT PHARMACY OF DESTREHAN, LLC
Entity type:Organization
Organization Name:NOLA DISCOUNT PHARMACY OF DESTREHAN, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:LOVE
Authorized Official - Last Name:CERNIGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:504-835-6060
Mailing Address - Street 1:3001 ORMOND BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-2545
Mailing Address - Country:US
Mailing Address - Phone:985-307-0800
Mailing Address - Fax:985-307-0808
Practice Address - Street 1:3001 ORMOND BLVD STE C
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-2545
Practice Address - Country:US
Practice Address - Phone:985-307-0800
Practice Address - Fax:985-307-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy