Healthcare Provider Details

I. General information

NPI: 1811645948
Provider Name (Legal Business Name): LAGNIAPPE PHARMACY 8 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 03/17/2022
Certification Date: 03/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1772 CANAL BLVD
THIBODEAUX LA
70301
US

IV. Provider business mailing address

311 E CORNERVIEW ST
GONZALES LA
70737
US

V. Phone/Fax

Practice location:
  • Phone: 985-447-3746
  • Fax: 985-447-2853
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DR. ERIC ANTHONY PETERS
Title or Position: MANAGING MEMBER
Credential: PHARM.D.
Phone: 225-810-7778