Provider Demographics
NPI:1356743751
Name:LAGNIAPPE PHARMACY
Entity type:Organization
Organization Name:LAGNIAPPE PHARMACY
Other - Org Name:
Other - Org Type:
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:225-402-4084
Mailing Address - Street 1:14639 AIRLINE HWY.
Mailing Address - Street 2:SUITE 114
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737
Mailing Address - Country:US
Mailing Address - Phone:225-402-4084
Mailing Address - Fax:225-402-4088
Practice Address - Street 1:14639 AIRLINE HWY.
Practice Address - Street 2:SUITE 114
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737
Practice Address - Country:US
Practice Address - Phone:225-402-4084
Practice Address - Fax:225-402-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA0069573336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy