Healthcare Provider Details
I. General information
NPI: 1649033648
Provider Name (Legal Business Name): COURTNEY PITRE ENTERPRISES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/01/2024
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
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
- Phone: 337-754-7481
- Fax: 337-886-5762
- Phone: 337-754-7481
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
COURTNEY
DUGAS
Title or Position: PIC
Credential: PHARMD
Phone: 337-754-7481