Provider Demographics
NPI:1194887349
Name:ALAMEDA THRIFTY PHARMACY INC
Entity type:Organization
Organization Name:ALAMEDA THRIFTY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:QUIJAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:915-772-5331
Mailing Address - Street 1:4900 ALAMEDA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2802
Mailing Address - Country:US
Mailing Address - Phone:915-772-5331
Mailing Address - Fax:915-772-9830
Practice Address - Street 1:4900 ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2802
Practice Address - Country:US
Practice Address - Phone:915-772-5331
Practice Address - Fax:915-772-9830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX192893336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4502173OtherNABP
TX144809Medicaid