Provider Demographics
NPI:1275607657
Name:THRIFT TOWN RX LLC
Entity type:Organization
Organization Name:THRIFT TOWN RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:ARNOLD DUVALL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:225-686-7241
Mailing Address - Street 1:PO BOX 238
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:LA
Mailing Address - Zip Code:70754-0238
Mailing Address - Country:US
Mailing Address - Phone:225-686-7241
Mailing Address - Fax:225-686-7888
Practice Address - Street 1:29680 FROST ROAD
Practice Address - Street 2:29680 FROST ROAD
Practice Address - City:LIVINGSTON
Practice Address - State:LA
Practice Address - Zip Code:70754
Practice Address - Country:US
Practice Address - Phone:225-686-7241
Practice Address - Fax:225-686-7888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2200992Medicaid
2132343OtherPK
LA1062660001Medicare NSC