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Provider Information for 1760479117


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TECHE DRUGS, INC.

Organization Subpart: NO

NPI: 1760479117
Last Updated: 2024-05-23
Certification Date: 2024-05-23

Details

NameValue
NPI1760479117
Enumeration Date2005-09-30
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: RYAN M DARTEZ
Title: President, Owner, PIC,AO
Phone: 3372354578
Mailing Address 509 JEFFERSON ST
LAFAYETTE, LA 70501-6905
United States

Phone: 337-235-4578 | Fax:337-235-4570
 
Primary Practice Address 509 JEFFERSON ST
LAFAYETTE, LA 70501-6905
United States

Phone: 337-235-4578 | Fax:337-235-4570
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDLA1234931
Other (non-Medicare)2028310PK
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 333600000X - Pharmacy
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyLAPHY-006091-IR