Provider Demographics
NPI:1871599498
Name:TERSCO LLC
Entity type:Organization
Organization Name:TERSCO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:BENINATO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:504-866-3784
Mailing Address - Street 1:8232 OAK ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70118-2042
Mailing Address - Country:US
Mailing Address - Phone:504-866-3784
Mailing Address - Fax:504-866-9902
Practice Address - Street 1:8232 OAK ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70118-2042
Practice Address - Country:US
Practice Address - Phone:504-866-3784
Practice Address - Fax:504-866-9893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X
LA5088IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2032490OtherPK
LA1270911Medicaid
LA1270911Medicaid
5CR51Medicare PIN