Healthcare Provider Details

I. General information

NPI: 1174659429
Provider Name (Legal Business Name): MICHELLE ANDRUS THRIFTY WAY OF BASILE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2007
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 STAGG
BASILE LA
70515-0472
US

IV. Provider business mailing address

PO BOX 426 3131 STAGG
BASILE LA
70515-0472
US

V. Phone/Fax

Practice location:
  • Phone: 337-432-6642
  • Fax: 337-432-6606
Mailing address:
  • Phone: 337-432-6642
  • Fax: 337-432-6606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number3213IR
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE NELSON ANDRUS
Title or Position: PHARMACIST
Credential:
Phone: 337-432-6642