Provider Demographics
NPI:1578317913
Name:KEN'S THRIFTY WAY PHARMACY AND HOME MEDICAL INC
Entity Type:Organization
Organization Name:KEN'S THRIFTY WAY PHARMACY AND HOME MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBERIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-942-8911
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:337-942-7551
Mailing Address - Fax:
Practice Address - Street 1:517 E PRUDHOMME ST
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6499
Practice Address - Country:US
Practice Address - Phone:337-942-7551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy