Provider Demographics
NPI:1912001348
Name:P & C HEALTHCARE LLC
Entity Type:Organization
Organization Name:P & C HEALTHCARE LLC
Other - Org Name:LAGNIAPPE PHARMACY 4
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PETERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:225-622-4817
Mailing Address - Street 1:40017 HIGHWAY 42
Mailing Address - Street 2:SUITE D
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-5240
Mailing Address - Country:US
Mailing Address - Phone:225-622-4817
Mailing Address - Fax:225-622-5229
Practice Address - Street 1:40017 HIGHWAY 42
Practice Address - Street 2:SUITE D
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-5240
Practice Address - Country:US
Practice Address - Phone:225-622-4817
Practice Address - Fax:225-622-5229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
LA3117IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1262501Medicaid
2033306OtherPK
2033306OtherPK