Provider Demographics
NPI:1043396914
Name:DELHI PHARMACY,INC
Entity Type:Organization
Organization Name:DELHI PHARMACY,INC
Other - Org Name:DELHI HEALTH MART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SCURRIA
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:318-878-5104
Mailing Address - Street 1:414 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-2940
Mailing Address - Country:US
Mailing Address - Phone:318-878-5104
Mailing Address - Fax:318-878-3291
Practice Address - Street 1:414 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-2940
Practice Address - Country:US
Practice Address - Phone:318-878-5104
Practice Address - Fax:318-878-3291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1250341Medicaid
LA1250341Medicaid