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NPI Code Detail

MEDICARE: THRIFTY PAYLESS INC

MEDICARE: THRIFTY PAYLESS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical SuppliesPHY-48745CA
23336C0003XCommunity/Retail PharmacyPHY48745CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25627849OTHEROTHER ID NUMBER

General Provider Information

NPI Number : 1265623003
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIFTY PAYLESS INC
Provider Business Mailing Address
First Line : 200 NEWBERRY COMMONS
Second Line :
City : ETTERS
State : PA
Zip : 17319-9363
Country : US
Telephone Number : 717-761-2633
Fax Number : 717-975-8659
Provider Business Practice Location Address
First Line : 16120 BEAR VALLEY ROAD
Second Line :
City : VICTORVILLE
State : CA
Zip : 92395-8706
Country : US
Telephone Number : 760-951-0210
Fax Number :
Authorized Official
Title or Position : MANG ONL ADJ
Name : JENNIFER ZOREK
Credential :
Telephone Number : 717-975-5937
Provider Enumeration Date : 08/07/2007
Last Update Date : 10/25/2011

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Directions to “THRIFTY PAYLESS INC ” Practice Location

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