Provider Demographics
NPI:1205145331
Name:PITRE, MARION (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARION
Middle Name:
Last Name:PITRE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 W TUNNEL BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2738
Mailing Address - Country:US
Mailing Address - Phone:985-223-2945
Mailing Address - Fax:985-223-8975
Practice Address - Street 1:1435 W TUNNEL BLVD
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2738
Practice Address - Country:US
Practice Address - Phone:985-223-2945
Practice Address - Fax:985-223-8975
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist