Provider Demographics
NPI:1184147571
Name:DELGADO, ELINA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ELINA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 GAUSE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2949
Mailing Address - Country:US
Mailing Address - Phone:985-280-8970
Mailing Address - Fax:
Practice Address - Street 1:901 GAUSE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2949
Practice Address - Country:US
Practice Address - Phone:985-280-8970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584501835P0018X
LAPST.0228281835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist