Provider Demographics
NPI:1073030672
Name:E5 PHARMA LLC
Entity Type:Organization
Organization Name:E5 PHARMA LLC
Other - Org Name:POINTE COUPEE PHARMACY 2
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:225-638-6321
Mailing Address - Street 1:222 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:NEW ROADS
Mailing Address - State:LA
Mailing Address - Zip Code:70760-2619
Mailing Address - Country:US
Mailing Address - Phone:225-638-6220
Mailing Address - Fax:
Practice Address - Street 1:222 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:NEW ROADS
Practice Address - State:LA
Practice Address - Zip Code:70760-2619
Practice Address - Country:US
Practice Address - Phone:225-638-6220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA166903336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy