Organization
GREENSBURG FAMILY PHARMACY LLC
Active
Other names
Greensburg Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TINNERELLO (MANAGER/OWNER)
(985) 320-5175
Entity
Organization
Contact information
Practice address
6166 HWY 10, GREENSBURG, LA 70441
(225) 222-4279
(225) 222-4043
Mailing address
1812 W THOMAS ST, HAMMOND, LA 70401-2945
(985) 345-4767
(985) 345-4768
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY.006667-IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139160
PK
—
05
—
2201930
—
LA
Enumeration date
02/25/2013
Last updated
07/22/2020
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