Organization
THRIFT-TOWN HEALTHMART, LLC
Active
Other names
Thrift-Town HealthMart Pharmacy, Thrift -Town Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EVANS RAY GLASGOW JR. RPH (OWNER PHARMACIST)
(985) 748-8191
Entity
Organization
Contact information
Practice address
512 N 2ND ST, AMITE, LA 70422
(985) 748-8191
(985) 748-5766
Mailing address
PO BOX 918, AMITE, LA 70422
(985) 748-8191
(985) 748-5766
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
6164IR
LA
332BC3200X
Customized Equipment (DME)
6164IR
LA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
6164IR
LA
332BX2000X
Oxygen Equipment & Supplies (DME)
6164IR
LA
333600000X
Pharmacy
6164 IR
LA
3336H0001X
Home Infusion Therapy Pharmacy
6164IR
LA
3336L0003X
Long Term Care Pharmacy
6164
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235245
—
LA
01
—
1903459
NCPDP
—
01
—
6164-IR
LA PHARMACY PERMIT
LA
Enumeration date
02/26/2007
Last updated
03/07/2023
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