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NPI Code Detail

MEDICARE: THRIFT CLINIC PHARMACY ON UNION, LLC

MEDICARE: THRIFT CLINIC PHARMACY ON UNION, LLC
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
1333600000XPharmacy6398LA
23336C0003XCommunity/Retail Pharmacy6398LA

General Provider Information

NPI Number : 1366739369
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIFT CLINIC PHARMACY ON UNION, LLC
Provider Business Mailing Address
First Line : 825 N UNION ST
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-6313
Country : US
Telephone Number : 337-948-4441
Fax Number : 337-948-4442
Provider Business Practice Location Address
First Line : 825 N UNION ST
Second Line :
City : OPELOUSAS
State : LA
Zip : 70570-6313
Country : US
Telephone Number : 337-948-4441
Fax Number : 337-948-4442
Authorized Official
Title or Position : PHARMACIST-IN-CHARGE
Name : MR. TERRY MENGARELLI
Credential : PD
Telephone Number : 337-948-4441
Provider Enumeration Date : 06/29/2011
Last Update Date : 06/29/2011

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Directions to “THRIFT CLINIC PHARMACY ON UNION, LLC ” Practice Location

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