Provider Demographics
NPI:1689904146
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:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERT
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:337-942-8911
Mailing Address - Fax:337-942-6764
Practice Address - Street 1:7591 I 49 S SERVICE RD
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-8154
Practice Address - Country:US
Practice Address - Phone:337-942-8911
Practice Address - Fax:337-942-6764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-06
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA21461406Medicaid
LA1226860001Medicare NSC