Provider Demographics
NPI:1568954345
Name:KENS THRIFTY WAY PHARMACY AND HOME MEDICAL INC
Entity Type:Organization
Organization Name:KENS THRIFTY WAY PHARMACY AND HOME MEDICAL INC
Other - Org Name:KEN'S THRIFTY WAY PHARMACY AND HOME MEDICAL-PORT BARRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVOIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-942-7551
Mailing Address - Street 1:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70571-1325
Mailing Address - Country:US
Mailing Address - Phone:337-447-4505
Mailing Address - Fax:337-381-3202
Practice Address - Street 1:418 SAIZON AVENUE
Practice Address - Street 2:
Practice Address - City:PORT BARRE
Practice Address - State:LA
Practice Address - Zip Code:70577
Practice Address - Country:US
Practice Address - Phone:337-447-4505
Practice Address - Fax:337-381-3202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7721333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2177952OtherPK