MEDICARE: THRIF T WAY PHARMACY OF LOUISIANA OPELOUSAS SOUTH 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	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	PHY.004433-IR	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2032200	OTHER	PK
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720176449
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIF T WAY PHARMACY OF LOUISIANA OPELOUSAS SOUTH INC

Provider Business Mailing Address
First Line	:	2961 S UNION ST
Second Line	:
City	:	OPELOUSAS
State	:	LA
Zip	:	70570-5740
Country	:	US
Telephone Number	:	337-948-7900
Fax Number	:	337-942-1535

Provider Business Practice Location Address
First Line	:	2961 S UNION ST
Second Line	:
City	:	OPELOUSAS
State	:	LA
Zip	:	70570-5740
Country	:	US
Telephone Number	:	337-948-7900
Fax Number	:	337-942-1535

Authorized Official
Title or Position	:	OWNER
Name	:	CARL SAVOIE
Credential	:	BS PHARMACY
Telephone Number	:	337-948-7900

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	06/24/2016

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