Organization
WINDFALL REAL ESTATE CORP
Active
Other names
JAGNEAUXS THRIFTY WAY
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA JAGNEAUX (OWNER)
(337) 585-2382
Entity
Organization
Contact information
Practice address
17695 HIGHWAY 190, PORT BARRE, LA 70577-5178
(337) 585-2382
(337) 585-2385
Mailing address
PO BOX 550, PORT BARRE, LA 70577-0550
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHY001123IR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1241229
—
LA
01
—
2029798
PK
—
Enumeration date
11/08/2006
Last updated
01/15/2016
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