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General NPI Number Information
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NPI Number | 1164481255
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Entity Type | Organization
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Legal Business Name | KENS THRIFTY WAY PHARMACY AND HOME MEDICAL INC
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 333 HEYMANN BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2415
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Country | US
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Telephone | 337-266-4621
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Fax | 337-266-5596
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Provider Business Mailing Address
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Address Line | 333 HEYMANN BLVD
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City | LAFAYETTE
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State | LA
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Zip | 70503-2415
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Country | US
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Telephone | 337-266-4621
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Fax | 337-266-5596
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. TAMMY S ROBERT
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Credential |
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Telephone | 337-942-7551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5617
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License Number State | LA
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