Healthcare Provider Details

I. General information

NPI: 1316036916
Provider Name (Legal Business Name): THRIFTY DRUG STORES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HORACE AVE N
THIEF RIVER FALLS MN
56701-2024
US

IV. Provider business mailing address

6701 EVENSTAD DR N STE 100
MAPLE GROVE MN
55369-6013
US

V. Phone/Fax

Practice location:
  • Phone: 218-681-2932
  • Fax: 218-681-5041
Mailing address:
  • Phone: 763-513-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number261151
License Number StateMN

VIII. Authorized Official

Name: TIMOTHY WEIPPERT
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 763-585-3507