Provider Demographics
NPI:1164789301
Name:CSAM ENTERPRISES, LLC
Entity Type:Organization
Organization Name:CSAM ENTERPRISES, LLC
Other - Org Name:FRIENDS & FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:KNAPP
Authorized Official - Last Name:LEBLANC
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:318-787-2817
Mailing Address - Street 1:2971 HIGHWAY 28 E
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71360-5716
Mailing Address - Country:US
Mailing Address - Phone:318-787-2817
Mailing Address - Fax:318-787-6802
Practice Address - Street 1:2971 HIGHWAY 28 E
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-5716
Practice Address - Country:US
Practice Address - Phone:318-787-2817
Practice Address - Fax:318-787-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA65023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy