Organization Active NPI

Magnolia Business Co, Inc. Dba 'Thrifty Way Pharmacy'

  • Community/Retail Pharmacy
  • Leesville, LA
National Provider Identifier
1144334129
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
6291-IR Issued in LA
Legal business name
MAGNOLIA BUSINESS CO, INC. DBA 'THRIFTY WAY PHARMACY'
Practice address
1019 Fertitta Blvd
Leesville, LA 71446
Phone
(337) 239-3474
Fax
(337) 238-2575
NPI assigned
Aug 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Debra Vermillion McCann, PHARMACIST (RPH)
Title
(Pic) Pharmacy Owner Corp-President
Phone
(318) 792-6231

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 662IR LA
Community/Retail Pharmacy 3336C0003X 6291-IR LA Primary
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

1019 Fertitta Blvd
Leesville, LA 71446

Mailing address

1019 Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-3474

Other identifiers 4

IdentifierTypeStateIssuer
1226050MedicaidLA
2200402MedicaidLA
1917991OtherNCPDP #
1917991OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • THRIFTY WAY PHARMACY Doing business as

National Provider Directory

National Provider Directory

Locations

1019 W Fertitta Blvd
Leesville, LA 71446
Phone (337) 239-3474

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1144334129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "71446",
            "telephone_number": "337-239-3474",
            "fax_number": "337-238-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 FERTITTA BLVD",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "71446",
            "telephone_number": "337-239-3474",
            "fax_number": "337-238-2575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA BUSINESS CO, INC. DBA 'THRIFTY WAY PHARMACY'",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "VERMILLION",
        "authorized_official_title_or_position": "(PIC) PHARMACY OWNER CORP-PRESIDENT",
        "authorized_official_telephone_number": "318-792-6231",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHARMACIST (RPH)"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "662IR",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "6291-IR",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1226050",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2200402",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP #",
            "identifier": "1917991",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1917991",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THRIFTY WAY PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leesville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.