Provider Demographics
NPI:1265402218
Name:THRIFTY WAY PHARMACY OF KAPLAN I
Entity type:Organization
Organization Name:THRIFTY WAY PHARMACY OF KAPLAN I
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:
Authorized Official - Last Name:GASPAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-643-6440
Mailing Address - Street 1:100 N CUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:KAPLAN
Mailing Address - State:LA
Mailing Address - Zip Code:70548-4908
Mailing Address - Country:US
Mailing Address - Phone:337-643-6440
Mailing Address - Fax:337-643-7214
Practice Address - Street 1:100 N CUSHING AVE
Practice Address - Street 2:
Practice Address - City:KAPLAN
Practice Address - State:LA
Practice Address - Zip Code:70548-4908
Practice Address - Country:US
Practice Address - Phone:337-643-6440
Practice Address - Fax:337-643-7214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPHY005901IR3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2030878OtherPK