Organization
PETES FAMILY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA ANTOON (OWNER/MANAGER)
(985) 514-3173
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
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2208365
—
LA
Enumeration date
02/09/2021
Last updated
05/26/2021
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