Provider Demographics
NPI:1164968491
Name:P & C HEALTHCARE LLC
Entity Type:Organization
Organization Name:P & C HEALTHCARE LLC
Other - Org Name:LAGNIAPPE PHARMACY 3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-402-4084
Mailing Address - Street 1:3490 DRUSILLA LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1866
Mailing Address - Country:US
Mailing Address - Phone:225-367-6488
Mailing Address - Fax:225-367-6850
Practice Address - Street 1:3490 DRUSILLA LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1866
Practice Address - Country:US
Practice Address - Phone:225-367-6488
Practice Address - Fax:225-367-6850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LAPHY007413IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2167142OtherPK