Provider Demographics
NPI:1548575442
Name:WOLFE, WILLIAM BLAIR (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BLAIR
Last Name:WOLFE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W JUDGE PEREZ DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-5002
Mailing Address - Country:US
Mailing Address - Phone:504-276-6192
Mailing Address - Fax:504-276-8106
Practice Address - Street 1:100 W JUDGE PEREZ DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-5002
Practice Address - Country:US
Practice Address - Phone:504-276-6192
Practice Address - Fax:504-276-8106
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15416183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist