Provider Demographics
NPI:1336251420
Name:WINGERTER, LOUIS PHILIP (RPH)
Entity type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:PHILIP
Last Name:WINGERTER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 BLUFF CT
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-8498
Mailing Address - Country:US
Mailing Address - Phone:985-626-7807
Mailing Address - Fax:
Practice Address - Street 1:2619 BLUFF CT
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-8498
Practice Address - Country:US
Practice Address - Phone:985-705-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14606183500000X
MS09383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0556050307Medicare ID - Type Unspecified