MEDICARE: THRIF-T-WAY PHARMACY OF ARNAUDVILLE 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	PHY.007037.IR	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2028457	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366509747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIF-T-WAY PHARMACY OF ARNAUDVILLE INC

Provider Business Mailing Address
First Line	:	412 OLIVE ST
Second Line	:
City	:	ARNAUDVILLE
State	:	LA
Zip	:	70512-6154
Country	:	US
Telephone Number	:	337-754-7481
Fax Number	:	337-754-7646

Provider Business Practice Location Address
First Line	:	412 OLIVE ST
Second Line	:
City	:	ARNAUDVILLE
State	:	LA
Zip	:	70512-6154
Country	:	US
Telephone Number	:	337-754-7481
Fax Number	:	337-754-7646

Authorized Official
Title or Position	:	PRESIDENT
Name	:	FRED STOUTE
Credential	:	PD
Telephone Number	:	337-754-7481

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	02/12/2015

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