Provider Demographics
NPI:1861581472
Name:THRIFTY DRUG STORES INC
Entity type:Organization
Organization Name:THRIFTY DRUG STORES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FROISTAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-513-4377
Mailing Address - Street 1:6701 EVENSTAD DR N STE 200
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-6026
Mailing Address - Country:US
Mailing Address - Phone:763-513-4300
Mailing Address - Fax:763-513-4380
Practice Address - Street 1:6701 EVENSTAD DR N STE 200
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-6026
Practice Address - Country:US
Practice Address - Phone:763-463-4400
Practice Address - Fax:763-463-4495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No291U00000XLaboratoriesClinical Medical Laboratory
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN606155000Medicaid
WI36228400Medicaid
2049098OtherPK
WI36228400Medicaid
870000771Medicare PIN