Provider Demographics
NPI:1649033648
Name:COURTNEY PITRE ENTERPRISES, LLC
Entity type:Organization
Organization Name:COURTNEY PITRE ENTERPRISES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:337-754-7481
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:ARNAUDVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70512-0280
Mailing Address - Country:US
Mailing Address - Phone:337-754-7481
Mailing Address - Fax:
Practice Address - Street 1:412 OLIVE ST
Practice Address - Street 2:
Practice Address - City:ARNAUDVILLE
Practice Address - State:LA
Practice Address - Zip Code:70512-6154
Practice Address - Country:US
Practice Address - Phone:337-754-7481
Practice Address - Fax:337-886-5762
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COURTNEY PITRE ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2203321Medicaid