Healthcare Provider Details

I. General information

NPI: 1538557152
Provider Name (Legal Business Name): COURTNEY PITRE ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 OLIVE ST
ARNAUDVILLE LA
70512-6154
US

IV. Provider business mailing address

PO BOX 280
ARNAUDVILLE LA
70512-0280
US

V. Phone/Fax

Practice location:
  • Phone: 337-754-7481
  • Fax: 337-886-5762
Mailing address:
  • Phone: 337-754-7481
  • Fax: 337-754-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.007037-IR
License Number StateLA

VIII. Authorized Official

Name: COURTNEY PITRE
Title or Position: OWNER
Credential:
Phone: 337-754-7481