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Contact Information

PETES FAMILY PHARMACY LLC
539 W RAILROAD AVE
INDEPENDENCE, LA70443
 Phone: 985-878-6321
 Fax: 985-878-4613
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for PETES FAMILY PHARMACY LLC

NPI Number 1285724336
LBN Legal business name PETES FAMILY PHARMACY LLC
Authorized official MICHAEL TINNERELLO - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2006
Last updated 05/01/2017 - About 9 years ago
Identifiers
LA License # PHY.006092-IR
LA Medicaid 1234958
Other 2028741 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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