Active NPI
Lisa N Prestenbach, RPH
- Pharmacist
- Thibodaux, LA
National Provider Identifier
1649282435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 13227
- Practice address
- 1772 Canal Blvd
Thibodaux, LA 70301-5225 - Phone
- (985) 447-3746
- Fax
- (985) 447-2853
- NPI assigned
- Aug 12, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 13227 | LA | Primary |
Addresses
Primary practice location
1772 Canal Blvd
Thibodaux, LA 70301-5225
Mailing address
3300 Highway 308
Napoleonville, LA 70390-8904
Phone (985) 447-3746
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13227 | LA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DMT Inc | Current | Accepting new patients |
Locations
1772 Canal Blvd
Thibodaux, LA 70301
Phone (985) 447-3746
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649282435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 HIGHWAY 308",
"city": "NAPOLEONVILLE",
"state": "LA",
"postal_code": "703908904",
"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": {
"last_name": "PRESTENBACH",
"first_name": "LISA",
"middle_name": "N",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "13227",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.