DMT Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY005681IR Issued in LA

Legal business name

DMT INC

Practice address

1772 Canal Blvd
Thibodaux, LA 70301-5225

Phone

(985) 447-3746

Fax

(985) 447-2853

NPI assigned

Jul 19, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Prestenbach, RPHNPI 1649282435

Title

Owner and Pic

Phone

(985) 447-3746

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• D AND M PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa N Prestenbach, RPH

  • Pharmacist
  • Thibodaux, LA
  • NPI 1649282435
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428537600000",
    "number": "1326067299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1772 CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015225",
            "telephone_number": "985-447-3746",
            "fax_number": "985-447-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1772 CANAL BLVD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015225",
            "telephone_number": "985-447-3746",
            "fax_number": "985-447-2853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2015-04-09",
        "status": "A",
        "authorized_official_last_name": "PRESTENBACH",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER AND PIC",
        "authorized_official_telephone_number": "985-447-3746",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY005681IR",
            "primary": true
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2029650",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234290",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "D AND M PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Robichaux Diedrich, MCD, CCC-SLP
• Emery Diggs, BA
• Michael Disalvo, LPC
• Matthew Disedare
• Divinity Home Health Services, LLC
• Truong Tony DO
• Brooke Kathleen Doalson, M.ED, LAT, ATC
• Gregory Dobard, M.D.
• Doctors Flynn Manceaux Arcement Pizzolato of Thibodaux a Professional
• Debra Gail Domangue, RPH

• Community/Retail Pharmacy in Thibodaux, LA
• Providers in Thibodaux, LA by specialty
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.