Provider Demographics
NPI:1568443703
Name:THRIFTY WAY PHARMACY OF ABBEVILLE INC
Entity Type:Organization
Organization Name:THRIFTY WAY PHARMACY OF ABBEVILLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MASON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-893-6304
Mailing Address - Street 1:2640 NORTH DR
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4043
Mailing Address - Country:US
Mailing Address - Phone:337-893-6304
Mailing Address - Fax:337-893-6306
Practice Address - Street 1:2640 NORTH DR
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4043
Practice Address - Country:US
Practice Address - Phone:337-893-6304
Practice Address - Fax:337-893-6306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-06
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1415 IR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0989030001Medicare NSC