Basic Information
| Provider Information | |||||||||
| NPI: | 1699081802 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FORSELL | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | LLOYD | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARM. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1929 ESPLANADE AVE | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701161706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044531586 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1601 PERDIDO STREET | ||||||||
| Address2: | VA MEDICAL CENTER | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701121262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8009358387 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/25/2010 | ||||||||
| LastUpdateDate: | 08/25/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 13056 | LA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.