Provider Demographics
NPI:1427133131
Name:CASHWAY PHARMACY OF ABBEVILLE LLC
Entity type:Organization
Organization Name:CASHWAY PHARMACY OF ABBEVILLE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:STUTES
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:337-893-2131
Mailing Address - Street 1:2509 CHARITY ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-4022
Mailing Address - Country:US
Mailing Address - Phone:337-893-2131
Mailing Address - Fax:337-893-2132
Practice Address - Street 1:2509 CHARITY ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-4022
Practice Address - Country:US
Practice Address - Phone:337-893-2131
Practice Address - Fax:337-893-2132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3022373001332B00000X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1270695Medicaid
LA1270695Medicaid