# PONCHATOULA FAMILY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ponchatoula Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477725638
- **Authorized official:** ANTHONY GERALD MERCANTE (PHARMACIST)
- **Authorized official phone:** (985) 386-0361

## Contact information

- **Practice address:** 19008 HIGHWAY 22, PONCHATOULA, LA 70454-6780
- **Practice address phone:** (985) 386-6556
- **Practice address fax:** (985) 386-6552
- **Mailing address:** 1812 W THOMAS ST, HAMMOND, LA 70401-2945
- **Mailing address phone:** (985) 386-6556
- **Mailing address fax:** (985) 386-6552

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | LA | Yes |

## Other

- **Enumeration date:** 03/28/2008
- **Last updated:** 11/12/2019