Healthcare Provider Details

I. General information

NPI: 1366509747
Provider Name (Legal Business Name): THRIF-T-WAY PHARMACY OF ARNAUDVILLE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 02/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 OLIVE ST
ARNAUDVILLE LA
70512-6154
US

IV. Provider business mailing address

412 OLIVE ST
ARNAUDVILLE LA
70512-6154
US

V. Phone/Fax

Practice location:
  • Phone: 337-754-7481
  • Fax: 337-754-7646
Mailing address:
  • Phone: 337-754-7481
  • Fax: 337-754-7646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY.007037.IR
License Number StateLA

VIII. Authorized Official

Name: FRED STOUTE
Title or Position: PRESIDENT
Credential: PD
Phone: 337-754-7481