Provider Demographics
NPI:1346497146
Name:CASHWAY PHARMACY OF YOUNGSVILLE
Entity Type:Organization
Organization Name:CASHWAY PHARMACY OF YOUNGSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RPH/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:STUTES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:337-856-8577
Mailing Address - Street 1:810 S. SAINT BLAISE LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592
Mailing Address - Country:US
Mailing Address - Phone:337-856-8577
Mailing Address - Fax:
Practice Address - Street 1:810 S. SAINT BLAISE LANE
Practice Address - Street 2:SUITE A
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592
Practice Address - Country:US
Practice Address - Phone:337-856-8577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6022-IR183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty