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Organization
DMT INC
Active
Organization
DMT INC
Active
Other names
D AND M PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA PRESTENBACH RPH (OWNER AND PIC)
(985) 447-3746
Entity
Organization
Contact information
Practice address
1772 CANAL BLVD, THIBODAUX, LA 70301-5225
(985) 447-3746
(985) 447-2853
Mailing address
1772 CANAL BLVD, THIBODAUX, LA 70301-5225
(985) 447-3746
(985) 447-2853
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
PHY005681IR
LA
3336M0003X
Managed Care Organization Pharmacy
—
NULL
Other
Enumeration date
07/19/2006
Last updated
04/09/2015
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