Pine Prairie Pharmacy,Inc

Primary specialty

PharmacistTaxonomy code 183500000X

License

5075-IR Issued in LA

Legal business name

PINE PRAIRIE PHARMACY,INC

Practice address

10711 Veterans Memorial Hwy
Pine Prairie, LA 70576

Phone

(337) 599-2050

Fax

(337) 599-2596

NPI assigned

Mar 24, 2006

Last updated

Apr 28, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Bart Enicke, RPH

Title

President/Pharmacist-in-Charge

Phone

(337) 599-2050

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1366402364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800",
            "city": "PINE PRAIRIE",
            "state": "LA",
            "postal_code": "705760800",
            "telephone_number": "337-599-2050",
            "fax_number": "337-599-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10711 VETERANS MEMORIAL HWY",
            "city": "PINE PRAIRIE",
            "state": "LA",
            "postal_code": "70576",
            "telephone_number": "337-599-2050",
            "fax_number": "337-599-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE PRAIRIE PHARMACY,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "ENICKE",
        "authorized_official_first_name": "BART",
        "authorized_official_title_or_position": "PRESIDENT/PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "337-599-2050",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "5075-IR",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1270733",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Betty Ventress Jordan, N.P.
• Kaitlyn Spears OT LLC
• Nick-Nard Inc (Fuselier's Pharmacy)
• Chelsea Faith Paul, FNP-C
• Pine Prairie Family Healthcare, LLC
• Play With Purpose Pediatric Therapy, LLC
• Prairie Manor, Inc. (Prairie Manor Nursing Home)
• Carmen Nicole Rollins, FNP
• Savoy Medical Management Group, Inc. (Pine Prairie Community Clinic)
• Debra Vidrine, APRN

• Pharmacist in Pine Prairie, LA
• Providers in Pine Prairie, LA by specialty
• Pharmacist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.