=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538557152
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COURTNEY PITRE ENTERPRISES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2015
-----------------------------------------------------
Last Update Date | 05/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 412 OLIVE ST
-----------------------------------------------------
City | ARNAUDVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70512-6154
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-754-7481
-----------------------------------------------------
Fax | 337-886-5762
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 280
-----------------------------------------------------
City | ARNAUDVILLE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70512-0280
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-754-7481
-----------------------------------------------------
Fax | 337-754-7646
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | COURTNEY PITRE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 337-754-7481
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | PHY.007037-IR
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------