Provider Demographics
NPI:1205912045
Name:BRINKHAUS THRIFTY WAY PHARMACY
Entity type:Organization
Organization Name:BRINKHAUS THRIFTY WAY PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CHIEF PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTTIE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KNOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PD
Authorized Official - Phone:337-662-5236
Mailing Address - Street 1:127 ACORN DR.
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-6100
Mailing Address - Country:US
Mailing Address - Phone:337-662-5236
Mailing Address - Fax:337-662-3999
Practice Address - Street 1:127 ACORN DRIVE
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6100
Practice Address - Country:US
Practice Address - Phone:337-662-5236
Practice Address - Fax:337-662-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5820 IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1902940OtherNABP
LA1215961Medicaid
LA1215961Medicaid