Provider Demographics
NPI:1043589005
Name:PILLAR ENTERPRISES
Entity Type:Organization
Organization Name:PILLAR ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BATISTE
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:225-268-2254
Mailing Address - Street 1:17668 GREENWELL SPRINGS ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-4708
Mailing Address - Country:US
Mailing Address - Phone:225-268-2254
Mailing Address - Fax:225-282-1004
Practice Address - Street 1:4919 JAMESTOWN AVENUE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-268-2254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS000000Medicaid