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General NPI Number Information
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NPI Number | 1497740245
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Entity Type | Organization
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Legal Business Name | POINTE COUPEE THRIF T WAY PHY
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3066 LA HIGHWAY 78
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City | LIVONIA
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State | LA
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Zip | 70755-3601
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Country | US
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Telephone | 225-637-2356
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Fax | 225-637-2855
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Provider Business Mailing Address
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Address Line | PO BOX 187
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City | LIVONIA
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State | LA
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Zip | 70755-0187
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Country | US
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Telephone | 225-637-2811
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Fax | 225-637-2811
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | MR. FRANK NED FOTI
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Credential | RPH
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Telephone | 225-637-2811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 696
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License Number State | LA
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