MEDICARE: BRINKHAUS THRIFTY WAY PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	5820 IR	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1902940	OTHER	LA	NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205912045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRINKHAUS THRIFTY WAY PHARMACY

Provider Business Mailing Address
First Line	:	127 ACORN DR.
Second Line	:
City	:	SUNSET
State	:	LA
Zip	:	70584-6100
Country	:	US
Telephone Number	:	337-662-5236
Fax Number	:	337-662-3999

Provider Business Practice Location Address
First Line	:	127 ACORN DRIVE
Second Line	:
City	:	SUNSET
State	:	LA
Zip	:	70584-6100
Country	:	US
Telephone Number	:	337-662-5236
Fax Number	:	337-662-3999

Authorized Official
Title or Position	:	PRESIDENT/CHIEF PHARMACIST
Name	:	MR. SCOTTIE JAMES KNOTT
Credential	:	P.D
Telephone Number	:	337-662-5236

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	05/21/2013

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