NPI 1912568718

Blake P Pitre

Practitioner Pharmacist Larose, LA

Practice location

Address: 13087 West Main St, Larose, LA 70363
Phone: (985) 693-7496
Fax: (985) 798-7997
Mailing address: 301 Roberta Grove Blvd, Houma, LA 70363-5465

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence PST.008604-G (LA)

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Registry record

NPI: 1912568718
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jun 2019
Record last updated: 24 Jun 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.