Healthcare Provider Details

I. General information

NPI: 1265402218
Provider Name (Legal Business Name): THRIFTY WAY PHARMACY OF KAPLAN I
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 01/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N CUSHING AVE
KAPLAN LA
70548-4908
US

IV. Provider business mailing address

100 N CUSHING AVE
KAPLAN LA
70548-4908
US

V. Phone/Fax

Practice location:
  • Phone: 337-643-6440
  • Fax: 337-643-7214
Mailing address:
  • Phone: 337-643-6440
  • Fax: 337-643-7214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberPHY005901IR
License Number StateLA

VIII. Authorized Official

Name: BRADY GASPAR
Title or Position: PHARMACIST
Credential:
Phone: 337-643-6440