Provider Demographics
NPI:1114575354
Name:LAGNIAPPE PHARMACY 6, LLC
Entity Type:Organization
Organization Name:LAGNIAPPE PHARMACY 6, LLC
Other - Org Name:LAGNIAPPE PHARMACY 6 LTC COMBO
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:225-810-7778
Mailing Address - Street 1:1717 S UNION ST STE 2
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-5745
Mailing Address - Country:US
Mailing Address - Phone:337-948-7703
Mailing Address - Fax:337-948-9975
Practice Address - Street 1:1717 S UNION ST STE 2
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-5745
Practice Address - Country:US
Practice Address - Phone:337-948-7703
Practice Address - Fax:337-948-9975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-30
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942108OtherNCPDP