Healthcare Provider Details

I. General information

NPI: 1205912045
Provider Name (Legal Business Name): BRINKHAUS THRIFTY WAY PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 05/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 ACORN DRIVE
SUNSET LA
70584-6100
US

IV. Provider business mailing address

127 ACORN DR.
SUNSET LA
70584-6100
US

V. Phone/Fax

Practice location:
  • Phone: 337-662-5236
  • Fax: 337-662-3999
Mailing address:
  • Phone: 337-662-5236
  • Fax: 337-662-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5820 IR
License Number StateLA

VIII. Authorized Official

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