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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 Supplies
23336C0003XCommunity/Retail Pharmacy

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15658185OTHERNCPDP

General Provider Information

NPI Number : 1982069704
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIFTY PAYLESS INC
Provider Business Mailing Address
First Line : 200 NEWBERRY CMNS
Second Line :
City : ETTERS
State : PA
Zip : 17319-9363
Country : US
Telephone Number : 717-975-5937
Fax Number : 717-975-8659
Provider Business Practice Location Address
First Line : 8509 IRVINE CENTER DRIVE
Second Line :
City : IRVINE
State : CA
Zip : 92618-4298
Country : US
Telephone Number : 717-761-2633
Fax Number :
Authorized Official
Title or Position : SR MANAGER PROVIDER ENROLLMENT
Name : JENNIFER ZOREK
Credential :
Telephone Number : 717-975-5937
Provider Enumeration Date : 12/21/2015
Last Update Date : 10/25/2016

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