Provider Demographics
NPI:1740394899
Name:BOYER'S THRIFT PHARMACY INC.
Entity Type:Organization
Organization Name:BOYER'S THRIFT PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DUGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-228-2064
Mailing Address - Street 1:PO BOX 568
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-0568
Mailing Address - Country:US
Mailing Address - Phone:337-228-2064
Mailing Address - Fax:337-228-2194
Practice Address - Street 1:1423 HENDERSON HWY.
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:LA
Practice Address - Zip Code:70517-0568
Practice Address - Country:US
Practice Address - Phone:337-228-2064
Practice Address - Fax:337-228-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14893336C0003X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1251488Medicaid