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Organization
PETES FAMILY PHARMACY LLC
Active
Organization
PETES FAMILY PHARMACY LLC
Active
Other names
PETES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TINNERELLO RPH (OWNER)
(985) 320-5175
Entity
Organization
Contact information
Practice address
539 W RAILROAD AVE, INDEPENDENCE, LA 70443
(985) 878-6321
(985) 878-4613
Mailing address
1812 W THOMAS ST, HAMMOND, LA 70401-2945
(985) 878-6321
(985) 878-4613
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006092-IR
LA
Other
Enumeration date
10/12/2006
Last updated
05/01/2017
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