Provider Demographics
NPI:1114055951
Name:SPITALE, LOUIS MICHAEL (RPH)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:MICHAEL
Last Name:SPITALE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 OLD SPANISH TRL
Mailing Address - Street 2:
Mailing Address - City:BERWICK
Mailing Address - State:LA
Mailing Address - Zip Code:70342-3126
Mailing Address - Country:US
Mailing Address - Phone:985-399-8491
Mailing Address - Fax:
Practice Address - Street 1:1200 N VICTOR II BLVD
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-1326
Practice Address - Country:US
Practice Address - Phone:985-255-4789
Practice Address - Fax:985-255-4788
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14550183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist