Provider Demographics
NPI:1083056584
Name:THRIFTY WHITE DRUG
Entity Type:Organization
Organization Name:THRIFTY WHITE DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:320-762-1534
Mailing Address - Street 1:503 3RD AVE E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-1503
Mailing Address - Country:US
Mailing Address - Phone:320-762-1534
Mailing Address - Fax:320-763-7582
Practice Address - Street 1:503 3RD AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-1503
Practice Address - Country:US
Practice Address - Phone:320-762-1534
Practice Address - Fax:320-763-7582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116035261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health