Provider Demographics
NPI:1588443253
Name:FARHOUD, SUENDUS
Entity type:Individual
Prefix:
First Name:SUENDUS
Middle Name:
Last Name:FARHOUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 GRANADA DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-1919
Mailing Address - Country:US
Mailing Address - Phone:504-345-0791
Mailing Address - Fax:
Practice Address - Street 1:2585 LEON C SIMON DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-5721
Practice Address - Country:US
Practice Address - Phone:504-284-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.025019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist