Organization
THRIFTY WAY PHARMACY OF DERIDDER INC NO 2
Active
Other names
THRIFTY WAY PHARMACY #2
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE ROY (VP)
(800) 430-3784
Entity
Organization
Contact information
Practice address
601 S PINE ST, DERIDDER, LA 70634-4941
(337) 463-7442
(337) 462-0362
Mailing address
601 S PINE ST, DERIDDER, LA 70634-4941
(337) 463-7442
(337) 462-0362
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY001316IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1216917
—
LA
01
—
2030865
PK
—
Enumeration date
08/10/2006
Last updated
04/17/2017
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