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General NPI Number Information
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NPI Number | 1942307780
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Entity Type | Organization
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Legal Business Name | THRIFTY WAY OF LAKE CHARLES, INC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 1001 3RD AVENUE
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City | LAKE CHARLES
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State | LA
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Zip | 70601
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Country | US
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Telephone | 337-433-1429
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Fax | 337-433-9971
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Provider Business Mailing Address
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Address Line | 1001 3RD AVENUE
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City | LAKE CHARLES
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State | LA
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Zip | 70601
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Country | US
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Telephone | 337-433-1429
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Fax | 337-433-9971
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MRS. JENNY T. NASH
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Credential | RPH
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Telephone | 337-433-1429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 6031IR
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 006031
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License Number State | LA
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