Organization
ENICKE ENTERPRISES INC
Active
Other names
Eastins Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JANA ENICKE (OWNER/PHARMACIST IN CHARGE)
(337) 831-5137
Entity
Organization
Contact information
Practice address
1535 W MAIN ST, SUITE 2, VILLE PLATTE, LA 70586-2867
(337) 363-6668
(337) 363-5072
Mailing address
1535 W MAIN ST, VILLE PLATTE, LA 70586-2867
(337) 363-6668
(337) 363-5072
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY006486IR
LA
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1262587
—
LA
01
—
2133677
PK
—
05
—
2201352
—
LA
Enumeration date
02/08/2007
Last updated
09/18/2014
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